June/July 2019 Nugget

the

June / July 2019

When to Refer -

From The Perspective of the Specialist A PUBLICATION OF THE SACRAMENTO DISTRICT DENTAL SOCIETY

Get Ready For Our

UPCOMING EVENTS 8TH ANNUAL

dinner. auction. dancing.

October 5, 2019 | 6:30pm | Hyatt Regency Hotel

This Gala is going to be a special one! This year we celebrate 125 years for SDDS and 50 years for the SDDS’ Foundation! The Gala includes a live auction, cocktails, dinner, and dancing, and is all in support of a great cause, the Foundation!

For more information about the Smiles for Sacramento Gala, please visit sdds.org/foundation

Shred, Snack and Sip

Friday, October 11th · 10:00am-2:00pm Enjoy snacks and frosty beverages as you get that pesky shredding out of your office and off your to-do list.

Maximum 10 banker size boxes. If you’re over 10 boxes, we’d appreciate a donation of $100 to the SDDS Foundation!

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Contents June / July 2019 VOLUME 65, NUMBER 6

10

When Should You Refer for a Surgical Consult

14 16 18

FEATURES

COVER IMAGE CREDIT: SHUTTERSTOCK

Jagdev Heir, DMD, MD

The Perio Perspective Khalid Rasheed, DDS

Pathway to the Endo Referral Eric Young, DDS, MMSc

Smile Straighteners— Who Should Be Treating Orthodontic Cases Brandon Martin, DDS, MS

22 Nugget Editorial Board Ash Vasanthan, DDS, MS • Editor-in-Chief Nima Aflatooni, DDS • Herlin Dyal, DDS, MS James Hastings, DDS • Tyler Holt, DDS Denise Jabusch, DDS • Gregory Kolber, DDS Grace Lee, DMD, MD • Brian Ralli, DDS

Editors Emeritus James Musser, DDS William Parker, DMD, MS, PhD Bevan Richardson, DDS

Awards

International College of Dentists (ICD) 2018 • Humanitarian Service Award 2017 • Special Citation Award, unusual concept 2016 • Golden Pen, honorable mention Article / series of articles of interest to the profession

2015 • Special Citation Award, unusual concept 2014 • Outstanding Cover, honorable mention 2014 • Golden Pen, honorable mention 2013 • Outstanding Cover 2012 • Overall Newsletter 2010 • Platinum Pencil Outstanding use of graphics

Having the Right View Abraham J. Priestley, DDS

Specials 7 24 28 36

Wanted: Your Stories About the Good in Dentistry 2019-20 Program at a Glance The 8th Annual Swing for Smiles Golf Tournament 2020 SDDS and SDDF Election Slate of Nominees

Regulars 5 6 7 9 21 23 26 30 32

President’s Message Cathy’s Corner From the Editor’s Desk You Should Know Job Bank Volunteer Opportunities Board Report YOU: The Dentist, The Employer Foundation

34 38 40 42 43 44 46 47 48

Committee Corner Trustee Report Membership Update Blowing Your Horn Vendor Member Spotlight Vendor Member Listings Advertiser Index Classified Ads SDDS Calendar of Events

2007 • Overall Newsletter 2007 • Outstanding Cover

The Nugget • Sacramento District Dental Society • www.sdds.org

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President's Message We're Ready...Are You? 2019 continues to streak forward like a 90mph fast ball—did someone say Dental Day at Raley Field? What a great time for families and dental teams to enjoy a wonderful event together. It was good seeing everyone there in this beautiful, outdoor venue.

The Smiles for Sacramento Gala on Saturday, October 5th will be an event truly not to be missed. Come celebrate 125 years of our wonderful Society and 50 years of our Foundation. Have you considered bringing your team with you? Register for a table of 10 or become a sponsor at various levels of participation. The Gala includes online and live auctions, cocktails, dinner and dancing, all in support of a great cause, our Foundation! We know a superb time will be had by all!

By Bryan Judd, DDS 2019 SDDS President

The year is chock full of growth and CE opportunities for all. The CE Committee has taken your feedback and put together an amazing line up. Starting this September and running through May of next year, look for CE on implants, digital pearls from local experts, and Manual Day where we can take care of updating OSHA, Employee, and HIPAA manuals all on one day.

The General Membership Meetings resume in September with Human Trafficking: How to Identify and Respond, continuing to Harassment Prevention, Protection and Politics. Again in January, we have the popular “SDDS Talk Night” 10 minutes, 10 slides, 6 speakers. Fast paced, informative, and more than relevant—take what you learn and use it tomorrow.

Shred Day is in October, a great member benefit; and November finds us supporting the arts—Dentists Do Broadway with the classic and hilarious A Christmas Story. We have Licensure Renewal basics, Business Forums, Webinars, and Lunch and Learns for the entire team. This has been a quick overview; I hope you take time to see how great, energetic and productive our vibrant Dental Society truly is; and it’s all to support you, the members. Thanks always to our great team at headquarters for their qualified, creative and caring personalities without whom we could not do what we do.

Bryan Judd, DDS

dental Practice Brokerage TEAM SACRAMENTO

PRACTICE SALES • VALUATIONS/APPRAISALS • TRANSITION PLANNING • PARTNERSHIPS • MERGERS • ASSOCIATESHIPS GREATER EL DORADO HILLS: Multi-doctor practice in approx. 3,000 sf office, possible 8 Ops, 7 equipped, I/O camera, Digital X-rays, and Digital Pan. Sellers will consider working back part-time. #CA578 GREATER SACRAMENTO: PPO Practice/Condo in a stable community for 33 yrs. in well-known dental and medical area. 1390+ sf office. 4 Ops, digital X-rays, imaging system, I/O camera. 2017 GR $652K. #CA561 GREATER SACRAMENTO: North Area: Modern 4 Op w/ 5th open, PPO practice, 1664 sf. Higher-end TI's and neighborhood, Gendex sensor, I/O camera, Nomad, Pano and Laser. 2017 GR $755K on 33 avg. hrs./wk. #CA550 GREATER SACRAMENTO: El Dorado Hills/Folsom Area: 3 Op, PPO practice.

Approx. 1399 sf. High-end TI’s and neighborhood, SoftDent, Carestream sensors, I/O camera. 2017 GR $506K on 4.25 day/wk. #CA543

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Dental suite is being sold with practice. Owner is retiring. #CA584 GREATER ROSEVILLE: General practice on busy thoroughfare in highly desirable Roseville location. Approx. 1,320+ sf office, 3 Ops with 4th plumbed. Dentrix, Dexis Digital sensors (2), I/O camera, and Nomad Pro 2 X-ray. About $70K in new computers & technology in 2016. Seller working P/T 16-20 hrs/wk. #CA490 SACRAMENTO: 3 Ops, shopping center location, digital X-rays, move in ready.

2017 GR $527K on 30 hrs/wk. 29 yrs. Goodwill. #CA527 SACRAMENTO: Downtown / Midtown Sacramento: High-traffic GP, 4 Op location with under 5% Delta Premier patients. 2018 GR $607K on 30 Dr. hrs/wk. #CA590 SACRAMENTO AREA: NEW LISTING! GP/Specialty HMO/some PPO Practice.

Approx. 5000 sf building avail. 9 Ops, digital sensors, imaging system, I/O camera, digital Pano. 2017 GR $1.1M. 2018 Quickbooks (to be verified) GR $680K. #CA567

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www.sdds.org • June / July 2019 2/12/2019

|5

Cathy's Corner LEADERSHIP

It's Out, It's Ready...

It's Here!

By Cathy B. Levering

SDDS Executive Director

For the last 10 months we have been working on setting up our program of speakers and topics for the upcoming program year, September 2019 through May 2020 and we are proud to say… IT’S HERE! The General Meeting topics (and great menus), the CE programs for Fridays and Lunch and Learns, the Business Forums, CPR, Licensure, OSHA and MidWinter program is stellar this year, and we are so proud to offer it to our SDDS members, their staff and other members throughout our area and beyond.

Please look at the program spread in the center of this issue of The Nugget – and plan your next year accordingly. Take particular look at the Friday CE courses – we have some great speakers and topics. To those SDDS members who are presenting some of our programs and speaking at General Meetings, thank you for saying yes!

Our program has come to fruition thanks to the input from all doctors and staff who attend our past programs. We try to take all your suggestions and present a program that you have suggested – hope you like it. We’re so excited!

Finally, please calendar February 6-7, 2020 for our MidWinter Convention for doctors and staff – we are in a new location in 2020, our 40th year of MidWinter. McClellan (the old Air Force base) will have 1500 FREE PARKING SPACES – a great incentive to attend, right?

Happy summer! 

August 3-4, 2019 Chico, Ca Silver Dollar Fairgrounds

In November 2018, the deadliest and most destructive wildfire in California history to date happened in the small, northern California retirement town of Paradise. The Camp Fire consumed more than 153,000 acres (240 square miles). 90% of the town burned to the ground in a matter of hours; 19,000 buildings were lost, including 13,954 homes.

On August 3 and 4, 2019, California CareForce will be hosting a clinic in the neighboring town of Chico, Ca, where many of the fire survivors now reside.

California CareForce is looking for dental volunteers for this event! For more information, and to sign up to volunteer, head to the link below!

californiacareforce.org/volunteer/chico 6 | The Nugget • Sacramento District Dental Society

President: Bryan Judd, DDS Immediate Past President: Margaret Delmore, MD, DDS President Elect/Treasurer: Carl Hillendahl, DDS Secretary: Volki Felahy, DDS Editor-in-Chief: Ash Vasanthan, DDS, MS Executive Director: Cathy Levering Jagdev Heir, MD, DMD, FACS Greg Heise, DDS Brock Hinton, DDS Kevin Keating, DDS, MS Matt Korn, DDS Hana Rashid, DDS Wesley Yee, DDS Amardeep Bains, DMD, BDS (Guest) Adrian Carrington, DDS Terry Jones, DDS CPR: Craig Alpha, DDS Ethics: Lisa Dobak, DDS Nominating/Leadership Development: Margaret Delmore, MD, DDS Peer Review: Morton Rosenberg, DDS CE Task Force: Eric Grove, DDS Forensics Advisory: Mark Porco, DDS Strategic Planning Advisory: Volki Felahy, DDS / Carl Hillendahl, DDS Budget & Finance Advisory: Carl Hillendahl, DDS Bylaws Advisory: Margaret Delmore, MD, DDS Legislative Advisory: Amardeep Bains, DMD, BDS Member Recruitment /Engagement: Jennifer Drew Mathisen, DDS, MSD / Ramesh Thondapu, DMD New Dental School Advisory: Kevin Keating, DDS, MS Oral Health Initiatives: Kim Wallace, DDS

EXECUTIVE COMMITTEE

BOARD OF DIRECTORS

TRUSTEES COMMITTEES STANDING

TASK FORCES ADVISORY COMMITTEES

Foundation: Viren Patel, DDS Golf Tournament: Charles Stamos, DDS SacPAC: Matt Campbell, DDS

SPECIAL EVENTS OTHER

Cathy Levering | Executive Director Anne Rogerson | Office Manager Jen Jackson | Community Projects / Recruitment Jessica Luther | Graphic Designer Megan Gormley | Special Events / Engagement Rachel Sheets | Graphic Designer Sofia Gutierrez | Foundation Projects / CPR

SDDS STAFF

The Nugget is an opinion and discussion magazine for SDDS membership.

Opinions expressed by authors are their own, and not necessarily those of SDDS or The Nugget Editorial Board. SDDS reserves the right to edit all contributions for clarity and length, as well as reject any material submitted.

The Nugget is published monthly (except bimonthly in June/July and Aug/Sept) by the SDDS, 2035 Hurley Way, Ste 200, Sacramento, CA 95825 (916) 446-1211.

Acceptance of advertising in The Nugget in no way constitutes approval or endorsement by Sacramento District Dental Society of products or services advertised. SDDS reserves the right to reject any advertisement.

Postmaster: Send address changes to SDDS, 2035 Hurley Way, Ste 200, Sacramento, CA 95825.

From the Editor’s Desk When to Refer – The Specialist's Perspective Last year, the SDDS devoted an issue on exploring how a typical general practitioner decides when to refer a patient to a specialist for advanced care. This ended up being a fruitful topic and also exposed that within our profession, this decision was many times informed by past failures, pressures from the patients, financial factors and other rather subjective factors.

Much like medicine, dentistry has clearly evolved into a very collaborative process with the general dentist taking on a more directorial role in complex cases involving the efforts of multiple specialists. At the same time, improvements in technology and availability of advanced training has also opened the door for general dentists to challenge themselves with a more expanded repertoire of procedures that might not have been typically undertaken in previous years.

In this issue, we will get the opinions of several varied specialists regarding this topic. Honestly, as a general dentist, it can

be intimidating discussing performing procedures that might fall under the traditional purview of a specialist. I think we do have a perverse fear of judgment in this regard. We have all run into our share of “ivory tower” judges who feel that no dentist should dare perform a root canal or pull a tooth. In my own course pursuing this topic, I've found the opposite to be the case more often than not. The general attitude that I have run into is that most specialists seem to have a strong desire to increase the level of awareness and knowledge of their particular specialty across the entire profession. Periodontists really want the typical general dentists to have a great knowledge base about gums and bone.

Orthodontists want dentists to understand occlusion and aesthetics. It seems that the typical specialist has a greater fear that disease is left untreated or undiagnosed rather than worrying about general dentists “moving in on their territory.”

By Brian Ralli, DDS

Associate Editor

That being said, there are also legitimate concerns of patient mistreatment. Very few would actually accuse a colleague of maliciously neglecting or harming a patient, yet it ultimately is the responsibility of the referring doctor to both recognize dental disease and know how it can be properly treated. It is no longer acceptable to ignore specific problems just because “we don't treat that here.” All dentists are obligated to offer their patients the opportunity to have their problem evaluated and discussed with the specific professionals who were trained to solve that problem. Hopefully the insight of the five authors in this issue will shed some light in the future decision making process for our readers and would perhaps encourage a more systematic and objective approach to the referral process. 

Wanted: Your Stories About the Good in Dentistry

By Denise Jabusch, DDS My good friend, and dental school classmate, was reluctant to share. I informed him that the topic of the December 2019 SDDS Nugget will feature uplifting stories about patient interactions and/or testimonials of an inspiring colleague. I, as the associate editor of the issue, am looking for member dentists to share personal experiences that have motivated them and at the end of the day, made them smile. Let’s face it, dentistry is physically and mentally challenging, and yet, when we meet a young college student, we extoll the virtues of our profession. What are the stories behind that enthusiasm?

The wife of my good friend enthusiastically shared a heart-rending story that, when my friend delivered some anterior crowns and gave the patient a mirror to see her new reflection, the patient cried in gratitude.

The patient was very grateful to my friend for improving her appearance and gave him the ultimate compliment.

If you have a story to share, whether it be inspiring, humorous, or touching, you can email me at djab2020@gmail.com. If writing is not your thing, you can tell me the story and I will write it for you. Hope to hear from you soon.  www.sdds.org • June / July 2019

|7

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YOU SHOULD KNOW CareForce needs your help in Chico: Volunteers are needed to help the Paradise fire victims.

The event in August 3-4, 2019. Sign up to volunteer at: Californiacareforce.org

ADPAC UPDATE

ADA RESPONDS TO ATLANTIC ARTICLE

Submitted by Gary Ackerman, DDS; ADPAC Board Member As your ADPAC representative from CDA to ADA I wanted to give everyone an update on what ADPAC has been doing for organized dentistry and dentistry in general. Some of you get emails from the ADA but if you don’t or did not read it below is a synopsis of the Dentist/ Student lobby Day held in Washington DC Over 1000 Dentist and dental students -ASDA attend the event and then actively go to Capitol Hill and meet with members of congress and their staff to lobby on behalf of dentistry. The dates this year were April 14-16. There are several bills that are being introduced and all of the bills are bi-partisan in the authors of the bill. Thanks for your support of ADPAC. Letter from Jeff Cole DDS - President of ADA ADA and ASDA members travelled to Washington D.C. to lend a collective voice to the legislative process that will shape the future of dentistry and public health. We held approximately 400 meetings with lawmakers from both sides of the aisle, and in one month, we have already seen dentistry’s impact.

A number of legislators have already agreed to co-sponsor bills that reflect our key advocacy priorities. Here are the preliminary results: • H.R. 1418, which repeals the anti-trust exemption of the McCarran-Ferguson Act, has gone from 12 co-sponsors to 22. Amending the McCarran-Ferguson Act would permit the application of the full range of federal antitrust laws against health insurance companies.

• The Student Loan Refinancing Act (H.R. 2186), which authorizes borrowers from the Federal Direct Loan Program to refinance their loans when interest rates are lower (per ADA and ASDA policy principles), has gone from 23 co-sponsors to 30.

• The Resident Education Deferred Interest Act, or REDI, (H.R. 1554) amends the Higher Education Act of 1965 to halt the accrual of interest and extend the loan deferment period while a dentist is completing a medical/dental internship or residency. This act has gone from 11 co-sponsors to 46.

• The Senate (S.560) and House (H.R. 1379) bills supporting the Ensuring Lasting Smiles Act (ELSA) went from five to nine co-sponsors and 32 to 73 co-sponsors respectively. ELSA would require health plans to cover medically necessary surgeries to fix congenital birth defects.

We saw some swift wins after Lobby Day 2018, and I am confident that the priorities communicated during Lobby Day 2019 will soon be added to our legislative successes. For the ADA and ASDA, this is the power of collaboration and advocacy at its best.

Fall 2019–Spring 2020

at a

Reprinted with permission from ADA In regards to an article written in The Atlantic entitled, “The Truth About Dentistry,” the ADA offers these talking points that you can share with your patients: • The American Dental Association and dentists across the country are dedicated to the health and safety of the patients they serve.

• The overwhelming majority of dentists are ethical practitioners, and that’s why dentists are consistently ranked among the most honest and ethical professionals, according to Gallup public opinion polls.

• I am a member of the ADA and when I joined, I agreed to abide by the ADA Principles of Ethics and Code of Professional Conduct. My patients’ trust is extremely important to me.

• The ADA is also dedicated to evidence-based dentistry. Evidence-based dentistry integrates the dentist’s clinical expertise, the patient’s needs and preferences, and the most current, clinically relevant scientific evidence. All three are part of the decision-making process for patient care.

In any healthcare profession, trust between a doctor and patient is of paramount importance.

We cannot let an isolated article such as this shake our patients’ faith in us as dedicated practitioners.

The above is an excerpt of an email from Jeffrey M. Cole, DDS, MBA; President; American Dental Association

Get your CE units THROUGH SDDS! SEE PAGES 24-25 FOR PROGRAM

www.sdds.org • June / July 2019

|9

WHEN TO REFER

When Should You Refer for a Surgical Consult

By Jagdev Heir, DMD, MD

SDDS Member

Dr. Heir is a practicing Oral & Maxillofacial Surgeon since 2006. Dr. Heir graduated with a Biochemistry degree from Rutgers University and went on to the University of Medicine & Dentistry of New Jersey.

He completed a Facial & Body Cosmetic Surgery Fellowship in Oklahoma City.

He is triple Board Certified in Oral & Maxillofacial Surgery, Facial Cosmetic Surgery, and General Body Cosmetic Surgery. He is also a Fellow of the American College of Surgeons (FACS).

He practices in Sacramento at Sacramento Surgical Arts.

During his free time, Dr. Heir enjoys spending time with his two boys, family and friends.

In the world of medicine as little as 50-60 years ago, family doctors were taking out gall bladders, delivering babies, treating the patient for tuberculosis, etc. The primary care doctor served as an internist, an obstetrician, a surgeon, a psychiatrist, and an ophthalmologist, to name a few services.

As new information and technology increased the complexity of the management of patients, the need for the role of the specialist became apparent. In present day, there is a team approach between the primary care doctor and the specialist where the primary care doctor is the hub at the center orchestrating the patient's care amongst a variety of specialists.

“First do no harm� always applies and it is without a qualifier.

Dentistry has a similar history. During pre-doctoral training, we learned and understood the basics of the entire scope of the dental practice including a basic education in all specialties. Those

routinely such as extractions, endodontic procedures, restorative failures, and local anesthesia. In addition, some of the fastest growing malpractice claims involve dentists getting involved in more advanced procedures such as implants, orthodontic treatment, or sedation/anesthesia.

Dentists are trained to practice to the best of their abilities and to recognize their ultimate limitations which would warrant a referral to the specialist. skills and techniques are refined later through advanced education, on the job experience, or ultimately a formalized specialty program. Dentists are trained to practice to the best of their abilities and to recognize their ultimate limitations which would warrant a referral to the specialist.

Not doing so is doing a disservice to the patient and our profession. The old adage,

10 | The Nugget • Sacramento District Dental Society

Nearly half of all patient complaints that eventually turn into lawsuits involve complications of many procedures that most dental professionals perform

One of the most common causes of medical malpractice is an untimely referral.

One of the strongest tools in a dentist's arsenal in order to prevent a malpractice lawsuit is a good informed consent system. Informed consent is not just a piece of paper but a multiple step process that includes discussion of the diagnosis, treatment, available alternative treatments, and reasonable risks and benefits associated with those treatments. Most importantly, there needs to be an opportunity for the patient to have asked and have answered all relative questions.

One of the most common causes of medical malpractice is an untimely referral. As with anything that we do, sometimes the outcome is less than ideal for a multitude Continued on on page 12...

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If everything is equal, then referring to someone because they are close or they take the patients’ insurance is viable but a proper referral to the best person qualified to handle the task is always the best idea. of reasons ranging from misdiagnosis, mistreatment, human error (doctor or patient), or unknown causes. Sometimes, ‘crap sometime just happens’. The best way to approach this is to recognize the complication or the disease state and to make the referral to the appropriate specialist.

appropriate imaging prior to commencing treatment is an absolute must. Splint or pharmaceutical therapy without a proper workup and diagnosis is negligence. Many serious conditions can be the ultimate cause of joint pain including disc dislocation, arthritis, or even osteosarcoma.

Referring to a specialist because they are convenient for the patient (geographically, financially, etc.) is also a potential pitfall.

If everything is equal, then referring to someone because they are close or they take the patients’ insurance is viable but a proper referral to the best person qualified to handle the task is always the best idea.

I have referred my own patients up to one mentor in Portland and another in New York because I felt they would do the best work for the patient despite the patient trusting in my own abilities. Are there closer referrals that I could have sent them to? Perhaps... However, I sent them to someone that I would trust with my own child or spouse with a similar situation.

If you have the proper training for conscious or IV sedation as defined by the Dental Board of California, have undergone an office inspection, have the proper emergency equipment, etc. then you have the right to administer this additional form of anesthesia on top of local anesthetics. A word of caution, however, anesthesia is 99.9% boredom and 0.1% sheer terror. No one ever knows when something might go terribly wrong

As an oral surgeon, I have a few tips for referring doctors to avoid the kind of pitfalls that can lead to those nightmare situations that all of us fear. Regarding oral pathology, a good rule of thumb is that if a lesion has not improved over two weeks, it should be referred. “Watching” an undiagnosed lesion is never a correct course of action. I have seen a patient whose doctor watched a lesion for five years and it had not changed. The dentist retired and the patient eventually came to me. After examining the patient, I biopsied the lesion and it came back as a malignant melanoma.

The patient has since undergone a massive resection without reconstruction and is being fed through a feeding tube. If you decide to cut something out, then it must be submitted for pathologic confirmation.

What may seem like a mucocele, could be a mucinous tumor for example.

Many patients might suffer from Temporomandibular Disorder (TMD) and Facial Pain. Again, I stress the need for proper diagnosis prior to treatment especially when prescribing narcotics.

Proper diagnosis utilizing a combination of a proper history, physical exam, and

...the most important aspect of a referral is proper communication with the patient and the specialist. very quickly. As with anything, we do professionally, we are a representative of our profession as a whole, and must hold ourselves accountable for everything we do. There have been too many deaths that have occurred in this area that have not painted us in the best light in the court of public opinion.

More and more general dentists are now placing implants. If you have the proper training, then go for it. However, as stated before, proper diagnosis and treatment planning is still the key to success. It's critical to know when bone needs to be augmented or when soft tissue needs to be grafted. While cone beam scans are not the standard of care, having one does not necessarily guarantee success, even for guided surgery. Don't use the cheapest components or materials, but you don't need the most expensive either. If a case ends up being better served by the expertise of the specialist, then they are available for you. If you do end up with the inevitable

12 | The Nugget • Sacramento District Dental Society

complication, never “sweep it under the rug” or hope for the best by observing it.

Refer it immediately.

All of the oral surgeons in the world could not take out all the teeth that need to be taken out thus it is foolish for anyone to get upset when a non-“surgeon” takes out teeth or performs specific dentoalveolar procedures. Before you do any surgical procedure, be sure you know the anatomy of the area you are working on, especially the lingual and inferior alveolar nerves.

For third molars, always take a panoramic x-ray which is the established standard of care. If you attempt a tooth extraction and then have to refer, understand that the standard of care is to perform a nerve examination prior to completing the extraction and a new panoramic x-ray is necessary as the anatomy has been altered.

In summary, the most important aspect of a referral is proper communication with the patient and the specialist. I have often said to the patient that your dentist did the right thing by referring you (especially in the case of a failed attempt or a complication). Something like this can happen to anyone, including me, but the fact that they recognized it and sent you over shows the level of knowledge and care that they provide to each of their patients.

Playing Monday-morning quarterback is easy, and it may make us feel good for a few seconds but patient care is a team approach.

The same applies even when a patient walks in from another surgeon. We are all part of a team, and do not need to make anyone look or feel bad. All of us have had complications that leave us scratching our heads, but we all have people that we trust and can call upon.

Happy referring folks. 

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| 13

WHEN TO REFER

The Perio Perspective

By Khalid Rasheed, DDS SDDS Member

Dr. Rasheed completed his dental degree from the University of California San Francisco and pursued a specialty in periodontics at the Oregon Health Sciences University. He is a diplomat within the American Board of Periodontology. Dr. Rasheed is a partner at Capitol Periodontal Group and practices in Sacramento, Roseville, and Elk Grove.

Dr. Rasheed enjoys the outdoors and is an avid martial arts enthusiast, achieving a second degree black belt in Tae Kwon Do.

Figures 1 & 2

A common question I get as a periodontist is “when should I refer a patient to you?�, a simple question, yet a very tailored answer to give every dentist. Although there are no concrete guidelines on when a referral is warranted by the ADA or even the AAP, all dentists should have the clinical experience and confidence to properly address the needs of their patients whether it requires intervention on their part or recommendation of the appropriate referral. The goals should be the same with any modality selected in the patient's treatment plan by either the general dentist or the periodontist: a) Arrest any signs of periodontal disease and/ or soft tissue inflammation; b) Reverse or impede attachment loss through soft or hard tissue regeneration; and c) Implement an appropriate maintenance protocol.

The management of periodontal disease is one of the most important yet complex tasks that all dentists must face. Almost universally, general dentists should be providing their patients with routine hygiene care and minimally offering scaling and root planing to those patients who have chronic periodontitis. Many modern offices now offer other adjunct therapies including laser therapy or locally delivered antibiotics. The rule of thumb should still be to regard any 6mm or greater pocket that has not positively responded to those therapies as a potential referral. These pockets are not maintainable over a long period of time and generally lead to a poor prognosis. Specifically, any class 2 or greater furcation involvement is something that can not be properly cleansed. Defects such as these or other vertical types of defects that have multiple walls for support can be great candidates for bone grafts or other types of guided tissue regeneration. (Figures 1 & 2).

Also be wary of aggressive forms of periodontitis. If a patient suddenly lost significant bone in a short period of time, that should be a warning sign that requires a proper diagnosis. In general, for the more

14 | The Nugget • Sacramento District Dental Society

advanced periodontal disease cases, it never hurts the patient to inform them of their options to manage their diseases. Many times treatment might just mean monitoring for further progression but there is never any harm in having a second set of eyes on a case whenever there is doubt. No patient will ever blame you for being concerned about the progression of their disease.

While we tend to focus on the radiographs and things like massive bony defects that jump right out at us, don't forget the equally important health of the soft tissue too. The gums are the seal that keep the bacteria in the mouth away from the bone. Patients with severe gum recession or lack of proper keratinized attachment just don't have that seal. Modern periodontics now has multiple methods that can restore the gums to their proper level of attachment. Many times the patient will bring it up to the doctor as a cosmetic concern, and many doctors will consider a restoration as an alternative.

Don't forget that we can't graft gum tissue to a composite! Patients with over 3mm of gingival recession should have their cases

Figures 3 & 4

evaluated by the periodontist or at least their case discussed with the periodontist with whom you work (Figures 3 & 4).

Patients with complex medical histories and co-morbities can also present a significant challenge to managing even lesser cases of periodontal disease. Patients with diabetes, cardiovascular disease, or even pregnancy are conditions that can have drastic effects on how a patient responds to therapy. Providers also want a firm understanding on how to time care for patients who have planned chemotherapeutic treatments to treat cancer and planned joint replacement therapy. Remember that not only can their disease affect their mouth, but active periodontal disease has clearly been shown to have an effect on the overall health of the body too.

Many general dentists now successfully place dental implants.

With any advanced dental procedure, one should always limit themselves to the level of their own expertise and ultimately what is best for the patient. Keep in mind that loss of a tooth almost always involves loss of bone too. Many implants do require a bone graft in association with the implant placement. If you can't place the implant where you would like it to be ideally or you can't place an adequately sized implant, consider a referral.

Periodontists and oral surgeons can many times add significant amounts of bone to an area, and this can ultimately make your life as the restorative dentist easier in the long run with a much more stable and aesthetically pleasing implant. Even an implant that seems like it is failing can many times be salvaged with surgical intervention. Here is a case of peri-implantitis in which I was able to graft and save the implant (Figures 5 & 6).

Figures 5 & 6 With the breadth of knowledge and clinical skills held by our very own dentists here in the Sacramento area, the aforementioned items may be within the scope of practice of many general dentists.

The important aspect to recall here is the ability to recognize when there may be an issue. In any clinical case that one may encounter, I always encourage and remind my fellow colleagues that we share a spirit of camaraderie. We are mutual allies. Reach out to a fellow colleague, a specialist, or even take the time to consult with a health care provider outside of dentistry who can give new insights or perspectives. Whatever the case may be, do not forget that we all said the words “Primum non nocere” as we donned with our white coats in dental school. It is our obligation to “Do no harm” to our patients. The inability or willful failure to appropriately treat or refer a commonly asymptomatic condition such as periodontal disease is doing just that. 

www.sdds.org • June / July 2019

| 15

WHEN TO REFER

Pathway to the

Endo Referral

By Eric Young, DDS, MMSc

SDDS Member

Dr. Young was born and raised in Sacramento, and graduated from the University of the Pacific Arthur A. Dugoni School of Dentistry in 2007 in San Francisco.

In 2008, he completed an Advanced General Dentistry residency in the US Army and went on to serve tours in Egypt and Afghanistan with the 3rd Special Forces Group. Dr. Young completed his residency training in Endodontics at Harvard University in Massachusetts. He practices dentistry at Creekside Endodontics in the Sacramento area.

Decisions about endodontic referrals can be tough. As dentists, our patients often look at us as experts of everything in the mouth.

But we are victims of our own success as patients believe that if we mechanically put the pieces in the correct places, that success will surely follow. Reality is that we are doctors treating injury and disease in a complex biologic setting under considerable forces outside of our control.

...we are doctors treating injury and disease in a complex biologic setting under considerable forces outside of our control.

When they believe that the product is undifferentiated, consumers often place greater value on time and convenience.

This can sometimes create a challenge for the dentist when the patient trusts their general dentist, and would prefer to stay in the office that they know. The dentist then needs to come to a decision to either perform the endodontic procedure that is more convenient for the patient or to refer to a specialist who may be better suited to offer the best technical possible outcome.

The other elephant in the room is that dentists are under economic pressure to continue to offer increasingly complex specialty procedures such as root canal therapies to move the needle as we grapple with astronomical student loans, business expenses, and the sky-high cost of living in the Golden State. A 2017 article in Dental Town Magazine, “Suck it up Buttercup!”

by Howard Farran, took this message to the extreme. “If you're afraid of doing a second molar for fear you might mess it up,

16 | The Nugget • Sacramento District Dental Society

do it! Worst-case scenario, push back the chair and say, “You know what? This tooth is a disaster. At this point I recommend removing it and spending your money on your other teeth.” While this sentiment may make sense in other professions, we serve patients and our first priority must always be what is in best interest of the patients instead of our own.

Such a cavalier attitude also proves to be penny-wise and pound foolish. The lifetime value over the length of the doctor-patient relationship may be as much as $30,000 and possibly more with good internal marketing.

These numbers are contingent on years of good experiences reinforcing the relationship.

A bad experience can send a patient running for the hills, not to mention the impact of possible bad online reviews and word of mouth. It is well documented that our brains are coded and hard-wired for a negativity bias as an evolutionary trait. This trait causes 86% of people who’ve had negative experiences to flee the practice and are then likely to tell somewhere between 9 and 20 of their closest friends about their bad day.

So how can you navigate these challenging pressures of patients valuing convenience and financial impacts to your practice?

When is it time to use a life-line and refer a patient to an endodontist? The short answer is whenever a patient’s needs are greater than the general practitioner’s capability or when the patient is better served in the hands of a specialist. We are all held

When is it time to use a lifeline and refer a patient to an endodontist?...whenever a patient’s needs are greater than the general practitioner’s capability...

to the same standard. The technical issues are well documented by the American Academy of Endodontists. The A AE developed the Endodontic Case Difficulty Assessment Form to help clinicians quickly evaluate a case and weigh it against their own experience. The AAE’s form helps in assessing a tooth’s rotation, the curvature of roots, clearly observable canals in radiographs, and the presence of crowns or posts. The guidelines help you with proper assessment of the risk so that you can provide a convenient positive service to a patient to avoid losing a valued customer and gaining negative reviews.

When I deliver lectures, I also suggest a series of truths that inform the decision making process as well as the conversation with the patient.

• Younger, healthier people have less problems than older, unhealthier people • Vital cases are more successful than necrotic cases

• Cases with small or no lesions are more successful than those with large lesions • Discuss expectations and success rates from the literature with the patient • Better visibility is correlated to greater success, so use more magnification and a great light source • Proper isolation is tied to success, so use a rubber dam!

Another key variable in this decision may be part and parcel of the conversation of how to manage the complexities of the patient and the tooth with the availability of new tools and techniques. Some of these tools such as microscopes and cone-beam computed tomography (CBCT) are amazing. They increase our visualization, improve our decision making, and amplify our dexterity.

If your office has the latest equipment, and you’re well versed on how to use it, that may provide you with additional information to help decide whether to refer. For example, many radiographs fail to show a clearly

differentiated MB2 making a missed canal a common problem. However, CBCT provides the best possible information on where to find all canals with accuracy. But before you call the sales representive to drop tens of thousands of dollars, all of those tools amount to fancy paper weights if we don’t have the opportunity to learn to wield them effectively.

Saving teeth for patients is incredibly rewarding. As a specialist, I take pride in our profession whenever I see a final radiograph showing a beautiful case and even more so after seeing that the patient has healed. Getting to that point requires an in depth understanding of the diagnosis, the pathology, the principles of treatment, the challenges of the case, and the utilization of the latest tools and techniques to maximize the chances for success. 

www.sdds.org • June / July 2019

| 17

WHEN TO REFER

Smile Straighteners—

Who Should Be Treating Orthodontic Cases

By Brandon Martin, DDS, MS

SDDS Member

Dr. Martin is a graduate of the UCSF School of Dentistry who then received his certificate in orthodontics and master’s degree from the University of Maryland. He is an active member of the AAO and practices at Alexander & Martin Orthodontics with offices in Rocklin, Roseville, and Sacramento.

Who’s the smile creation gate keeper? The orthodontist? The dentist?

Or can this just happen through the mail?

The current orthodontic market feels more like the island from "Lord of the Flies" than the established business model most of us have been comfortable with for generations. The traditional model was based on conscientious primary care dentists monitoring the developing occlusion for irregularities and referring out to orthodontic specialists who would manage care. Twenty years ago, more and more general dentists opted to begin treating orthodontic cases in their own offices rather than referring to outside specialists for various reasons including difficulty coordinating inter-disciplinary treatment, perceived lack of quality specialist care, or the desire to keep the production in their own offices rather than actively sending potential revenue out the front door.

Next, Invisalign treatment came on the scene. Many general dentists who were hesitant to get into the unfamiliar and somewhat unpredictable world of wires and brackets, felt more secure moving teeth on a computer screen. Clear aligner therapy (CAT) comfortably allowed practitioners

Esthetic, life-style, and patient convenience factors drove market share. to fabricate and deliver plastic aligners to straighten teeth. The digital workflow allows doctors to plan and visualize the end result before committing. Doctors then monitor treatment, anticipating that the simulated results will accurately translate into a healthy, esthetic occlusal reality. Initially, CAT had mixed clinical outcomes. Regardless, this

18 | The Nugget • Sacramento District Dental Society

new technology offered smile seekers the treatment alternative they wanted. Esthetic, life-style, and patient convenience factors drove market share. As practitioners have become more experienced moving teeth with plastic and clinical protocols have become more refined, it is safe to say CAT is here to stay.

The latest disruption to the orthodontic landscape is the capability to straighten teeth remotely. Five years ago, many orthodontists were concerned that general dentists were treating patients without the same level of training and experience that most orthodontists have. Now, the quickest growing orthodontic demographic is a group of consumers who never set foot in a general dental or orthodontic office. Instead, clear aligners are delivered directly to the consumer’s home through the mail. The growth rate of direct-to-consumer aligners is staggering. These patients do not physically see a dentist. Screening tools to protect the orthodontic patient such as an intra-oral exam, joint evaluation, periodontal analysis, or X-rays are not part of the process. Despite these limitations, the demand for these services is growing rapidly. By eliminating the traditional role of the dentist or orthodontist, treatment is offered at a greatly reduced price and on the consumers’ time frame, rather than the business hours and availability of the treating office. These disruptive changes have intensified the focus on the question – who should be treating orthodontic cases?

In this article, I will address several issues related to this question. First, what are the legal implications of direct-to-consumer orthodontic care. Next, I’ll briefly review competency and what standard of care means. Finally, as Continued on page 20...

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| 19

members of the SDDS, we have all agreed to abide by the CDA Code of Ethics. What ethical considerations are at stake?

Legally. Let’s start with the elephant in the room: is direct-to-consumer orthodontic care legal? As of last count, there are over 10 direct-to-consumer orthodontic companies (SmileDirectClub, Candid Co, SnapCorrect, Orthly, Smilelove, Byte, Orthly, etc). These companies make straightening teeth sound easy, convenient, and safe. Initial tooth position and consumer-produced intra-oral photos are reviewed remotely by a licensed dentist. The concept is new and currently working its way through the legal system. Only time will tell if the treatment process complies with individual state laws and regulations.

A general dentist can legally provide any dental services in which they are competent, including orthodontics. It is left to the individual practitioner to decide whether they are competent and if the treatment is within their scope of practice.

Competency. As noted, it is left to the individual dentist to determine if they are competent.

Currently, the majority of dental schools include only a brief overview of orthodontic theory, the biology of tooth movement, and limited, if any, clinical orthodontic experience. Dental school orthodontic training is focused on diagnosing abnormalities in dental development, jaw growth, occlusion, and knowing when to refer to an orthodontist. Once in practice, many dentists wish to expand their range of services and depth of knowledge but are faced with a significant “educational void.” To fill this educational gap, continuing education courses have been created that range from two-day weekend “accreditations” at the Holiday Inn Express to extensive multi-year learning experiences. The CDA states “maintaining competence requires continual self-assessment about the outcome of patient care and involves a commitment to lifelong learning.”

Ethically. As SDDS members, we have all agreed to follow the CDA Code of Ethics.

One of the fundamental principles of the Code of Ethics is beneficence. We are obligated to minimize harm and maximize benefit for our patients. The code states “the dentist refrains from harming the patient by referring to those with specialized expertise when the dentist’s own skills are insufficient.” This means that we should truthfully evaluate our own level of knowledge and experience and refer to those with advanced expertise when our own skills are lacking. As our professional journey progresses, there are areas where we become clinical “experts” and areas where we could be stronger. It is important to look inward and be honest with ourselves – we cannot always be the expert. I refer out to my colleagues frequently when faced with clinical situations where I realize there are others in my dental community that could better help a patient. For example,

I have seen mediocre cases treated by specialists, and I have seen beautiful results rendered by general dentists.

I feel I can handle most joint problems.

Occasionally, I have a patient with significant symptoms that are beyond my comfort level.

While I could make them a splint, I refer these patients to those I feel can better serve them.

Often, these are dentists that have chosen to dedicate their career and limit their practice to treating the joint and orofacial pain. While I may deal with these patients a few times a week – those with advanced expertise deal with these patients all day, every day and are simply better equipped to treat at a higher level of care

than I am. While I have chosen to develop my expertise with aligners and labial braces, I have not adopted lingual orthodontics. When I have patients interested in esthetic options, I review lingual orthodontics and other esthetic alternatives. If the patient feels lingual may be their best fit, I refer to my colleagues who have invested the time and effort to become proficient in the technique.

In closing, a specialty certificate on the wall does not always equate to superior treatment results. We all have cases we are not proud of -- where treatment just did not work out as planned. I have seen mediocre cases treated by specialists, and I have seen beautiful results rendered by general dentists. If we are honest, ethical, continually learning, and putting our patients’ needs before our own, everyone will come out smiling. Where does this leave us?

• Be your best: work within your competency. If you want to do more, then learn more. Continuing education and investing in your professional development will increase the range of clinical cases you can treat.

• Be honest: perform a self-evaluation of your own level of expertise. If there are those with a higher level of expertise, ethically you should refer.

• Be thorough: if there are other viable treatment alternatives that you do not offer, inform and educate patients and refer out if needed.

• Be kind: don’t disparage the work of others. Focus on how general dentists and specialists can work together for the benefit of the patient and our dental community. 

McClellan Park, S acramento february 6-7, 2020 Make sure to save the date for our upcoming MidWinter Convention! This year the convention will be held at McClellan Park while the Convention Center undergoes remodeling.

A great part of being at McClellan Park is that there will be FREE parking! The event space will also allow for us to include hands-on courses this year too!

20 | The Nugget • Sacramento District Dental Society

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Job Bank

The SDDS Job Bank is a service offered only to SDDS Members. It is published on the SDDS website and provides a forum for job seekers to reach other Society members who are looking for dentists to round out their practice, and vice versa. If you are a job seeker, associate seeker, selling or buying a practice, contact SDDS at (916) 4461227. For contact information of any of the job bankers please visit www.sdds.org.

ASSOCIATE POSITIONS AVAILABLE Jenny Apekian,DDS • Sacramento • F/T • GP Childrens Choice Pediatrics • Sacramento • PT/FT • Peds Robert Catron, DDS • Cameron Park • PT/FT • GP Mark Redford, DMD • Roseville/Granite Bay • PT • GP Kevin Chang, DDS • Roseville • PT • GP Michael Hinh, DDS • Sacramento • PT • GP Anthony Dang, DDS • Rancho Cordova • PT • GP Alison Trout, DDS • Rocklin • PT • Children only Teresa DeGuzman, DDS • Fair Oaks/Roseville • PT • GP Ricky Tin, DDS • Elk Grove • PT • GP April Westfall, DDS • So. Lake Tahoe • PT/FT • GP R. Bruce Thomas, DDS • Davis • PT/FT • GP Jason Scorza, DDS • Sacramento • PT/FT • GP Amy Woo, DDS • Sacramento • 1 day/wk • Endo Make A Smile • Sacramento • PT/FT • Pedo/Ortho/Endo/OS SmileTime • Sacramento • PT/FT • GP Jacqueline Delaney, DMD • Truckee • FT • GP Paul Raskin, DDS • Sacramento • FT/PT • Prosth Weideman Pediatric & Orthodontics • Citrus Heights • FT (4-5 days) • Ortho Kids Care Dental • Bay Area • Ortho Sean Avera, DDS • Auburn • Perio Ana Maria Antoniu, DMD • Sacramento • FT/PT • GP Amy Woo, DDS • Sacramento • PT • GP Matt Comfort, DDS • Roseville • FT/PT • GP Christopher Schiappa, DDS • Pioneer • PT • GP Quynh-Trang Pham, DDS • Sacramento • PT • GP Hoang Truong, DDS • Natomas/Roseville • FT/PT • GP Eloisa Espiritu, DDS • Lincoln • FT/PT • GP David Park, DDS • FT/PT • GP Gilbert Limhengco, DDS • Natomas/Citrus Heights • PT • Endo Kids Care Dental & Ortho • Calvine/Elk Grove • FT • GP, Ortho Elizabeth Johnson, DDS • various Wellspace locations • FT/PT/Fill-In • GP

DOCS SEEKING EMPLOYMENT Devon Lowry, DDS • FT • GP Sarah Mathai, DDS • PT/FT • GP Diya Talwar Hill, DDS • PT • GP Robert Nisson, DDS, MSD • PT • Ortho Kavneet Bindra, DDS • PT • GP Bruce Taber, DDS • Fill-In • GP Steve Murphy, DMD • FT/PT • Endo

CA DRE License #01422122

www.sdds.org • June / July 2019

| 21

WHEN TO REFER

Having the Right View

By Abraham J. Priestley, DDS

SDDS Member

Dr. Priestley is a board certified Pediatric Dentist with the American Board of Pediatric Dentistry and member of the College of Diplomates. He received his Doctorate of Dental Surgery at the University of Pacific School of Dentistry.

Following dental school, he completed a hospital based general practice residency program at St. Barnabas Hospital in Bronx, NY, then completed a specialty residency program in pediatric dentistry at Oregon Health and Science University. Dr. Priestley practices at Cali Kids Dental in Auburn, CA and Roseville Kids Dentist in West Roseville.

Working as a pediatric dentist, I tend to hear the same story from parents time and time again, “We’ve been going to the dentist every six months since their first birthday, and now there are several cavities? Just 6 months ago we were told that they had no cavities.”

These cases are referred to my office several times every month, where a child who has for years presented with nice, healthy looking teeth finally shows evidence of visible decay prompting a referral for treatment.

Proximal contacts had been present between primary molars for a number of years, but radiographs had never been obtained. By this point, bitewing radiographs can commonly reveal numerous carious lesions of varying size between primary molars in contact.

Often when a primary tooth shows visible evidence of decay, these teeth require pulpal treatment. In a non disparaging manner to either the parent or referring provider, it is important to explain how and where caries tend to develop as well as diagnostic tools used to detect such interproximal lesions.

Unfortunately, while the parents can be hard on themselves in these scenarios, and despite reassurance by myself and staff, these parents often express that they feel loss of confidence in the expertise of the referring provider.

It was then decided that radiographs should be obtained on the younger sibling (age 4) as well, and caries were noted on interproxmial contacts of all primary molars. The referring doctor had only seen a single visible lesion on the older child (figures 3 & 4).

Figures 3 & 4 Both siblings did well for all treatment in the office with the use of nitrous oxide.

Composite restorations were the treatment of choice with the exception of the molar lesion that had been the only lesion clinically detectable by the referring doctor which was treated with a pulpotomy and a full coverage restoration.

In the first case, two siblings were referred.

The older sibling (age 6) began to show clinical signs of caries on a lower left first molar. Radiographs were then obtained for the first time and interproximal lesions were noted on all lower primary molars. The lesion that had been detected clinically was large and would require a pulpotomy and full coverage restoration (figures 1 & 2).

In the second case, a patient was seen at our office who was seen for their first dental visit at age 4. The patient was fearful and uncooperative for xrays. No decay was evident on clinical evaluation. The patient then returned for recall examination 6 months later and this time we were able to obtain xrays after noticing a frank cavity on the lower left primary molar. Radiographs revealed multiple large carious lesions on several posterior teeth. Treatment was completed in office with the use of nitrous oxide. First molars were treated with pulpotomies and full coverage restorations while second molars were treated with composite restorations (figures 5 & 6).

Figures 1 & 2

Figures 5 & 6

The following are a few examples of such cases:

22 | The Nugget • Sacramento District Dental Society

Volunteer opportunities SMILES FOR KIDS So what can be done differently to try and avoid such scenarios?

Certainly this type of situation could happen to any provider even a pediatric one. We should attempt to put all the pieces of the puzzle together as early as possible in order to make appropriate dietary and hygiene recommendations, and perform minimally invasive interventions before lesions have a chance to progress.

This begins by establishing a foundation of trust at a young age, facilitating early detection and improving successful treatment outcomes. Comprehensive exams should include a caries risk assessment that evaluates dietary habits, social background, caregiver's caries status, fluoride exposure, and hygiene routine. A visual exam should include an evaluation of presence of plaque, staining, shadowing, enamel defects, and or white spot lesions.

The presence of any one of the previously mentioned would put a patient in the high risk category for caries according to the American Academy of Pediatric Dentistry. This would also be an indication for radiographs on teeth with proximal contacts every 6 months for patients 3 year of age and older. If a high risk patient is unable to cooperate for radiographs or the office is not equipped for pediatric xrays, then a referral to a pediatric dentist would be appropriate.

A policy statement on ethical responsibilities, “the AAPD believes it is unethical for a dentist to ignore a disease or condition because of the patient's age, behavior, and or disabilities. Dentists have an ethical obligation to provide therapy for patients with oral disease or to refer patients whose needs are beyond the skills of the practitioner to specialists.” In my opinion, this obligation includes proper diagnosis and treatment planning. A pediatric dentist may not always have better luck obtaining radiographs than a referring provider, but often times the change of environment alone may yield tremendous success with patients who had previously been shy or timid. It could simply be that a pediatric dental office has a kid friendly atmosphere, or that the staff is accustomed to working with children day in and day out. Or perhaps it’s the timid child seeing that other kiddos are doing well with cleanings, x-rays and even procedures. The referral of a high risk, fearful patient ensures that all measures have been taken to prevent, detect and treat any lesions as early and minimally invasive as possible. This best serves the patient, parents, and referring providers in order to maintain trust and prevent the frustration associated with late caries identification.

There is no magic wand, and pediatric dentists are caught in the same situations from time to time as well. Establishment of a dental home, a caries risk assessment, and radiographs in areas of proximal contact for high risk patients beginning at a young age is critical to ensure that minimally invasive treatment can be rendered. This way, the patients, parents and dentists can all be happier with the outcome. 

VOLUNTEERS NEEDED: Doctors to “adopt” patients for Smiles for Kids for follow-up care.

TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • smilesforkids@sdds.org)

SMILES FOR BIG KIDS VOLUNTEERS NEEDED: Dentists willing to “adopt” patients for immediate/emergency needs in their office.

TO VOLUNTEER, CONTACT: SDDS office (916.446.1227 • sdds@sdds.org)

September 27-28, 2019 • San Bernardino TO VOLUNTEER: www.cdafoundation.org/cda-cares AUBURN RENEWAL CENTER CLINIC VOLUNTEERS NEEDED: General dentists, specialists, dental assistants and hygienists.

TO VOLUNTEER, CONTACT: Dr. Steve Holm (916.425.6766 • sholm@goldrush.com)

THE GATHERING INN VOLUNTEERS NEEDED: Dentists, dental assistants, hygienists and lab participants for onsite clinic.

TO VOLUNTEER, CONTACT: Kathi Webb (916.743.5351 • kwebbft@aol.com)

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(COALITION FOR CONCERNED MEDICAL PROFESSIONALS)

VOLUNTEERS NEEDED: General Dentists, Specialists, Dental Assistants and Hygienists.

TO VOLUNTEER, CONTACT: CALL! (916.925.9379 • CCMP.PA@JUNO.COM)

EVERYONE FOR VETERANS SDDS is partnering with the national program, Everyone for Veterans, to provide care for COMBAT veterans and their families who cannot afford, nor have military coverage, dental care. Can you adopt a vet? Hope so!

Call SDDS (916.446.1227), or email us (sdds@sdds.org), to help us with this wonderful program.

For More Information: everyoneforveterans.org/for-dentists.html

www.sdds.org • June / July 2019

| 23

Fall 2019–Spring 2020

Program Glance at a

Get your CE units THROUGH SDDS!

general meetings

continuing education

SEPTEMBER 10, 2019 TUE · 3 CEU, core

SEPTEMBER 20, 2019 fri · 3 CEU, core

Human Trafficking: How to Identify and Respond to Victims in the Clinical Setting Ron Chambers, MD, FAAFP & Jennifer Cox

OCTOBER 8, 2019 TUE · 3 CEU, core

Harassment Prevention, Protection and Politics Mari Bradford, CEA (this satisfies the 1 hr requirement for employees)

NOVEMBER 12, 2019 TUE · 3 CEU, core

Healing your Heart: The Gut, Brain and Heart Connection Steve Peters, MD

Denti-Cal, GMC Billing Symposium Panel of Experts

SEPTEMBER 27, 2019 fri · 5 CEU, core

Digital Pearls in the Backyard

Richard Jackson, DDS; Brock Hinton, DDS; David Hatcher, DDS; Christian Favero, DDS, MSD

OCTOBER 25, 2019 fri · 2 CEU, core / 2 CEU, 20%

HR Solutions – For the Practice Owner (and Supervisors) Gail Whaley, JD & Jessica Hawthorne, JD

NOVEMBER 8, 2019 FRI · 5 CEU, core

Implants Made Easy

JANUARY 14, 2020 TUE · 3 CEU, core

“SDDS Talk” Night – 10 on 10 (10 Minutes, 10 Slides, 6 Speakers)

David Roholt, DDS; Brandon Martin, DDS, MS; Joelle Speed, DDS, MS; Jagdev Heir, DMD, MD; Alexander Antipov, DDS; Ash Vasanthan, DDS, MS

Jim Eggleston, DDS

MARCH 20, 2020 fri · 5 CEU, 20%

Claims, Compliance and Communication – What’s the Magic Combination?

Christine Taxin

MARCH 10, 2020 TUE · 3 CEU, core

MARCH 27, 2020 fri · 5 CEU, core

Leon Assael, DDS

Bernice Ko, DDS & Todd Yamada, DDS, MS

Oral Surgery in the General Dental Office: From Pitfalls to Professional Fulfillment APRIL 14, 2020 TUE ·

3 CEU, core

Top 10 Reasons Why Implants Fail or Look Ugly!

Jim Eggleston, DDS

The Endodontic-Periodontal Problem: Treatment Integration APRIL 24, 2020 fri · 6 CEU, core

Manual Day: Build & Complete Your OSHA, Employee & HIPAA Manuals in One Day! Teresa Pichay, CDA; Speaker TBA, CEA

MAY 12, 2020 TUE · 3 CEU, core

Taking the Bite Out of California’s Tooth Decay

SDDS Classroom • See registration forms for times

Jayanth Kumar, DDS; California State Dental Director

3 CEU, core • 5:45pm – 9:00pm • Sacramento Hilton, Arden West

licensure renewal cpr bls course AUGUST 9, 2019 FRI (8AM) NOVEMBER 15, 2019 FRI (8AM) JANUARY 22, 2020 WED (6PM) APRIL 25, 2020 SAT (8AM) 4 CEU, core • SDDS Classroom

24 | The Nugget • Sacramento District Dental Society

OCTOBER 18, 2019 FRI

California Dental Practice Act, Infection Control, and OSHA Refresher Leslie Canham, RDA

MAY 29, 2020 FRI

California Dental Practice Act, Infection Control, and OSHA Refresher Marcella Oster, RDA

2, 2, 2 CEU, core • SDDS Classroom • 8:30am–3:00pm

business forums

lunch & learns

SEPTEMBER 18, 2019 WED · 2 CEU, 20%

SEPTEMBER 25, 2019 WED · 2 CEU, 20%

Working with Dental Benefit Contracts in Your Practice Cindy Hartwell; CDA

SEPTEMBER 30, 2019 MON · 2 CEU, core

The Strength of Your TEAM is the Strength of Your Practice Helen Yee; Gallup Certified Strength Coach

Study Clubs, Mutual Aid Groups – Why They’re Important?

NOVEMBER 6, 2019 THU · 2 CEU, CORE

OCTOBER 16, 2019 WED · 2 CEU, 20%

LaDonna Drury Klein; FADE (SDDS Vendor Member)

Panel of Experts

OSHA – Train the Trainers – Then Train your Team

Top 10 Practice Management Tips…

Like Floss, They Work!

SDDS Classroom • 11:30am–1:30pm

Gayle Suarez; Dental Management Solutions

MARCH 19, 2020 THU · 2 CEU, 20%

Compliance, Fraud and Embezzlement, Oh My! Christine Taxin

APRIL 22, 2020 WED · 2 CEU, 20%

Become the Ultimate Data-Driven CEO Kerry Straine; Straine Consulting

MAY 28, 2020 THU · 2 CEU, 20%

Vendor Members – the Best Member Benefit!

Roundtables – Meet Our SDDS Vendor Members

SDDS Classroom • 6:30pm–8:30pm

Special Events

Shred, Snack and Sip! OCT 11, 2019 10am-2pm SDDS Parking Lot

DEC 13, 2019

6-11pm • Del Paso Country Club

Dentists Do Broadway NOVEMBER 2019

APRIL 2020

JANUARY 2020

MAY 2020

MARCH 2020

Dates announced in mid/late July

Swing for Smiles Golf Tournament MAY 8, 2020

Dental Day at Raley Field RiverCats Game JUNE 2020

CHRISTMAS STORY

hr webinars AUGUST 7, 2019 WED · 1 CEU, CORE

OSHA – What “They” Look For OCTOBER 9, 2019 WED · 1 CEU, 20%

Leave Laws

NOVEMBER 13, 2019 WED · 1 CEU, 20%

Alternative Workweeks

JANUARY 22, 2020 WED · 1 CEU, 20%

New Employment Laws for 2020 MARCH 25, 2020 WED · 1 CEU, 20%

Crucial Conversations, Hiring, Firing, Performance Issues

Annual Holiday Party,

Installation, Silent Auction, & Dancing

DEAR EVAN HANSEN BRONX TALE

Empire Ranch

BANDSTAND

COME FROM AWAY

Raley Field

GALA! To Benefit the Foundation OCTOBER 5, 2019 6:30pm • Hyatt Regency Sacramento

MAY 20, 2020 WED · 1 CEU, 20%

CSI HR – Investigating Workplace Problems SEPTEMBER 5, 2019 THU · 1 CEU, CORE

Harassment Prevention Training for Employees OCTOBER 3, 2019 THU · 2 CEU, CORE

Harassment Prevention Training for Supervisors NOVEMBER 7, 2019 THU · 1 CEU, CORE

Harassment Prevention Training for Employees DECEMBER 5, 2019 THU · 2 CEU, CORE

Harassment Prevention Training for Supervisors

MidWinter February

6-7, 2020

Webinars • See registration forms for times

www.sdds.org • June / July 2019

| 25

Board Report May 7, 2019

Volki Felahy, DDS

Highlights of the Board Meeting President Call to Order and Welcome

Secretary

help us create a great program. Next year is our 40th year of MidWinter, vintage red, white and blue. Also, possibly honoring the vets with a discount certificate if they show up in uniform.

Dr. Judd welcomed all Board Members to the meeting. Dr. Judd asked if there were to be any additions to the agenda and none were noted.

• Upcoming Program at a Glance: It is important that Board Members attend all the meetings. Also, the new brochure for the Foundation was handed out.

President’s Report Dr. Judd talked about the loss of SDDS Past President, Dr. Neil Loveridge and his many contributions to dentistry both at the local level and state and the service time and location honoring his life. Dr. Judd also thanked Dr. Wes Yee for agreeing to move up as incoming secretary.

• The 2019 Directory will be printed by the end of May and mailed in June.

• Cathy reported on the DTI Budget: The total budget is 132K not including the roll over from last year of 30K. Cathy went through the numbers explaining each section. The puppet show has served 5000 kids this year to date!

Secretary’s Report Dr. Felahy reported our market share at 82.3% at yearend 2018. It was a great year for membership.

committee. Possibly moving the committee from standing to an “as needed schedule” to be effective.

• Others: Last March LDC meeting: entire slate of nominees presented to the board. It was approved for the entire slate of nominees move forward for election in May (delegates) and September (all others).

Alternate delegates names presented and were approved.

New Business… New Ideas Cathy talked about the opportunity to be a Gala table sponsor: three handouts were given out: sponsorship opportunities, registration handout, all should attend, donation form, give for a good cause!

Trustee Report

Treasurer’s Report

Old Business

No report currently. Next meeting is scheduled for June.

Dr. Judd, Dr. Hillendahl and Cathy Levering reviewed the year-end report.

Our Dental Society is in good shape and in addition had a good year, even though December investment income… was not good. It has recovered to date in 2019.

MidWinter Wrap up - 650 people attended, plus 70 vendors and 150 reps attended, net in the positive for the event. Bills are being paid still but the bottom line looks to be the best ever!

Committee Updates / Liaison Reports

Adjournment

SDDS Bylaws will be changed to reflect all CDA and ADA membership changes.

Executive Director’s Report • MidWinter Wrap up: largest net in the history of the program, even in light of the higher fixed costs, thanks to our sponsors and exhibitors. Please help us support our sponsors; they

26 | The Nugget • Sacramento District Dental Society

• Legislative Advisory Committee update - Dr. Bains reported that CDA came to speak to their committee, they talked about Prop 56. Talked about loan repayment for new dentists treating low income patients. Working on tax for sugar sweetened beverages.

• Botox update: CDA did attend the DBC meeting in May (botox was not on the DBC agenda). More information coming soon!

• Survey update from the Legislative Advisory Committee: conclusion, members do not know what the CDA or the SDDS advocate legislatively on their behalf. Dr. Bains explained the value of the

The meeting was adjourned at 8:25pm Next Board Meeting: September 3, 2019 at 6pm

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www.sdds.org • June / July 2019

| 27

$18,000

Raised by this year’s tourney for the SDDS Foundation!

THIRTY-SIX Awesome Sponsors

ZERO 100 Hole-in-ones

PLAYERS

Thank you to the following for their generous DONATIONS!

28 | The Nugget • Sacramento District Dental Society

THANK YOU TO OUR SPONSORS 2019 SWING FOR SMILES

GOLF BALL SPONSOR Liberty Dental Plan

SUNSCREEN SPONSOR Access Dental Plan

HOT DOG SPONSOR Kid’s Care Dental & Orthodontics

BLOODY MARY SPONSOR Henry Schein

BLOODY MARY MIX SPONSOR Preservation & Co.

HOLE IN ONE SPONSORS Bender Insurance Solutions • W.F. Gormley & Sons

PUTTING CONTEST SPONSOR US Army Healthcare Recruiting

BEER CART SPONSORS DESCO • Integrity Practice Sales Parc Studio • Resource Staffing Group

WATER SPONSOR

The Winning Foursome

Endodontic Associates

Kevin Chen, DDS Larry Cao, DDS Khalid Rasheed, DDS Bobby Jackson

TEE SPONSORS

All photos can be seen on our Facebook page https://www.facebook.com/sddsandf

Bank of the West • Blue Northern Builders • BPE Law Group California Bank & Trust • Capitol Periodontal Group Daft & Stamos • Dentsply Sirona - Restorative The Foundation for Allied Dental Education First Citizen’s Bank • Mass Mutual • MUN CPAs Olson Construction, Inc. • Sierra Foothills Oral Surgery Tri Counties Bank • US Bank • Welch State Farm Agency

GREEN SPONSORS Heise & Alpha OMS • Holt Orthodontics • Morgan Stanley Prosthodontic Dental Group • Sierra Office Supplies Wells Fargo • The Yee Family

www.sdds.org • June / July 2019 2018

| 29

YOU

YOU ARE A DENTIST. You are also an employer. Employee evaluations, hiring and firing, labor laws and personnel files are an important part of that. This monthly column, will offer current employment law information pertinent to you —

THE DENTIST, THE EMPLOYER

the dentist, the employer.

BER MEM IT! F E N E B

Harassment Prevention Training

SDDS HR Hotline NEW EXCLUSIVE NUMBER FREE TO SDDS MEMBERS!

888.784.4031

By California Employers Association (SDDS Vendor Member) and independent contractors are counted toward the minimum 5 person count.

Have you heard the news?

SB 1343, requires that all employers of 5 or more persons provide 1 hour of sexual harassment and abusive conduct prevention training to non-managerial employees and 2 hours of sexual harassment and abusive conduct prevention training to managerial employees by January 1, 2020.

Existing law requires on-line, on-site or webinar trainings to be interactive and include practical examples of harassment.

Training must be provided by trainers or educators with knowledge and expertise in those areas.

Also, in determining whether you employ 5 or more persons under the new law keep in mind that: • There is no requirement that the 5 persons work at the same location or that all work or reside in California.

If you have additiona l questions about harassment prevention training requirements, check out CEA’s Harassment Prevention Training Fact Sheet.

Meet the Training Deadline Bad News: DFEH has stated that “employees who were trained in 2018 or before will need to be retrained.”

Good News: The California Employers Association (CEA), our HR Hotline provider, provides harassment prevention training!

CEA is here to help you comply with California’s employment laws and make sure your workplace is safe and respectful for everyone. Be sure to sign up for one of our upcoming trainings. 

• Under the DFEH’s regulations, full-time, part-time, temporary

Upcoming Harassment Prevention Training Webinars For Employees - all employees must have one hour of harassment prevention training before the end of December 2019.

Sept. 5, 2019 (Sold Out) • November 7, 2019 Our upcoming October General Meeting will also satisfy the one hour requirement for employees, so sign up now!

12-1pm • 1 CEU, Core • $49 each or $39 group rate for 3 or more signed up

For Supervisors/Employers - all supervisors/employers must have two hours of harassment prevention training before the end of December 2019.

October 3, 2019 • December 5, 2019 12-2pm • 2 CEU, Core • $59 each

Get Signed Up Today!

30 | The Nugget • Sacramento District Dental Society

Upcoming HR Webinars AUG

7

HR Webinar OSHA – What “They” Look For 1 CEU, 20% • $59

Learn what OSHA is looking for, common violations, and current trends in 2019. This session will provide attendees with a “show and tell” approach using photos of violation/nonviolation situations so you can apply what you’ve learned in your workplace, and more!

OCT

9

HR Webinar Leave Laws

1 CEU, 20% • $59

California Leave Laws are confusing! With over 20 different leave laws, how do you know if your company has to provide the leave and/or which of your employees are eligible to take time off work? If someone is eligible, how do you document and apply the time off accurately?

Learn these and more!

NOV

13

HR Webinar Alternative Workweeks 1 CEU, 20% • $59

In California, employers may create Alternative Workweeks which allow their employees to work longer shifts and avoid overtime penalties.

However, implementing an alternative workweek schedule requires strict adherence to state guidelines. Join us for our webinar to learn all of the steps for the successful implementation of an Alternative Workweek.

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SDDS Foundation Fundraising for our Wonderful Foundation Our Foundation does so much good in our community! Last month, in our May Foundation issue of The Nugget, we featured stories from many of our dentists who participate in the different projects of the Foundation, as well as a few articles from the patients themselves that our Foundation was able to help! We hope you enjoyed these heartwarming stories and that they helped you see a glimpse into the wonderful things our Foundation is able to do!

The Sacramento District Dental Foundation is funded solely through contributions, bequests, fundraising events, donation of services, planned giving and grants. There are so many opportunities throughout the year to help contribute to our Foundation!

All the contributions we receive help make our Smiles for Kids, Smiles for Big Kids, and other programs possible. Some of our

fundraising opportunities, you may already be participating in without realizing! A portion of each ticket purchased in our Dentists Do Broadway series goes towards the Foundation! The Annual Golf Tournament raises thousands of dollars each year! The contributions we receive on Shred Day each fall go directly to the Foundation as well!

There are also the more obvious fundraisers like your Foundation Dues, the Big Day of Giving and Giving Tuesday! Our Gala, coming up this fall, directly benefits our Foundation and is sure to be a big hit (the Gala is on October 5th, hope to see you there!).

Money Raised from Recent Fundraisers!

Thanks to all the contributions we receive from you each year, we are able to do so much good in the community! We appreciate the support immensely and hope to continue making a difference in the lives of our community! 

SACRAMENTO DISTRICT DENTAL FOUNDATION DOES…

broadway Dates will be announced in September!

NOVEMBER 2019 A CHRISTMAS STORY The songwriting team behind the smash hit Tony Award®winning musical Dear Evan Hansen brings the classic 1983 movie to hilarious life on stage! The New York Times writes “I was dazzled. You’d have to have a Grinch-sized heart not to feel a smile spreading across your face.”

JANUARY 2020 DEAR EVAN HANSEN A letter that was never meant to be seen, a lie that was never meant to be told, a life he never dreamed he could have. Evan Hansen is about to get the one thing he’s always wanted: a chance to finally fit in. Dear Evan Hansen is the deeply personal and contemporary musical about life and the way we live it.

32 | The Nugget • Sacramento District Dental Society

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MARCH 2020 A BRONX TALE Broadway’s hit crowd-pleaser takes you to the stoops of the Bronx in the 1960s, where a young man is caught between the father he loves and the mob boss he’d love to be. Bursting with high-energy dance numbers and original doo-wop tunes A BRONX TALE is an unforgettable story of loyalty and family.

APRIL 2020 BANDSTAND From Tony® winner and Hamilton choreographer Andy Blankenbuehler, comes an inspiring new American musical that explodes with infectious music and high-octane, heart-stopping dancing. Six soldiers return from war in 1945 and, through the power of music, finally find a place to call home.

MAY 2020 COME FROM AWAY Journey into the remarkable true story of 7,000 stranded passengers and the small town in Newfoundland that welcomed them. Cultures clashed and nerves ran high, but uneasiness turned into trust, and gratitude grew into enduring friendships.

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www.sdds.org • June / July 2019

| 33

Committee Corner 2019 SDDS Committees Schedule Standing Committees CPR Committee Aug 9 • Nov 15

Ethics Sept 25

Nominating/Leadership Development Work Completed

Peer Review Committee TBA

Foundation Foundation Board Jul 30 • Nov 11

Golf Tournament Work Completed

Advisory Committees Mass Disaster/Forensics Advisory Fall Date TBA

Nugget Editorial Advisory Sep 25

Strategic Plan Advisory Schedule as needed

Budget and Finance Advisory Schedule as needed

Bylaws Advisory Schedule as needed

Legislative Advisory TBA

New Dental School Advisory TBA

Leadership Board of Directors Sep 3 • Nov 5

Executive Committee Aug 2 • Oct 4 • Dec 6

Task Forces Member Engagement/Recruitment Sep 16

Oral Health/Prop 56 Initiatives Dec 6

Other Sac Pac TBA

CDA House of Delegates Nov 15-17

Legislative Survey Results (and more) As the Legislative Advisory Committee Chair I would like to thank everyone who responded to our recent survey. As a committee, we felt it was important to find out from our members what mattered most so that we can bring about the necessary change to help serve you best.

Of the close to 1300 members surveyed, 211 chose to participate. A 16% turnout is not ideal but certainly provides a good starting point. Of those who responded, 67.7% indicated they did not know what legislation the CDA was advocating for on their behalf.

77.62% did not know what legislation the SDDS was advocating for on their behalf.

Where does this disconnect stem from? How can we engage the membership? What are the next steps?

All questions that rightly come about from the data. Clearly, many of the newer graduates tend to spend a lot more of their time on social media and in between long hours at work, managing family commitments and so on there is seemingly little time for legislative engagement. This is a trend that must change. Be it local, state or national level, engagement matters.

Organized dentistry participation is one of the ways we can help shape our future and that of future generations; I hope through the SDDS you will help us in making the necessary positive changes.

The CDA is working on several measures on our behalf and we shall continue to support them on these. Some of the proposals being worked on include: Prop 56 -Tobacco tax funding to increase Denti-Cal provider reimbursement rates, student loan repayment programs, network leasing transparency, silver diamine fluoride coverage as well as tackling sugar sweetened beverages to name a few.

34 | The Nugget • Sacramento District Dental Society

By Amardeep Bains, DMD, BDS

Legislative Advisory Committee Chair

In addition, as was apparent from our survey, Employment and HR issues were the two most commonly identified as creating the biggest challenges in your practice. We are constantly striving to help our membership engage easily and we are working on a whole host of proposals to help serve you and keep you better informed.

SDDS has a fantastic range of courses available that cover many of the concerns that were voiced. Outside the conventional CE courses, look out for the many webinars available including several upcoming on the latest Harassment and Prevention Training requirements. In addition, as SDDS members, the California Employers Association HR Hotline is one that can prove to be an invaluable resource and one that I would encourage you all to utilize should the need arise. I have emphasized the importance of social media engagement.

Through the SDDS page, look out for updates on legislature as well as CE including Webinars on Facebook and in the very near future Instagram.

We are committed to improving our service to you. As such, the Legislative Advisory Committee moving forward will be assembled as called upon by the Board when significant legislative issues arise. As you may know, Botox is a topic that will certainly be relevant moving forward and we look forward to providing you with the necessary updates as well as advocating on your behalf on this topic.

Thank you for your continued support!

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www.sdds.org • June / July 2019

| 35

It's Time For...

SDDS ELECTIONS NOTICE OF ANNUAL MEETING & ELECTIONS

Elections will be held at the September 10, 2019 General Meeting The Leadership Development Committee is tasked with guiding the future of SDDS by evaluating and nominating leaders for our organization. The committee met in the first quarter of 2019 and considered a very strong slate of candidates. We are pleased to report that the outlook is good with the following members listed below being nominated for 2020. SDDS is only as good as its volunteers and we appreciate all who give back to our organization.

Margaret Delmore, MD, DDS (Chair of the Leadership Development Committee)

SOCIETY SLATE OF NOMINEES SDDS EXECUTIVE COMMITTEE To be Elected:

President: Carl Hillendahl, DDS President Elect/Treasurer: Volki Felahy, DDS Secretary: Wes Yee, DDS Immediate Past President: Bryan Judd, DDS

TRUSTEE

To be Elected:

Wallace Bellamy, DMD

BOARD OF DIRECTORS To be Elected:

Craig Alpha, DDS Lisa Dobak, DDS Matt Korn, DDS (2nd term)

Jagdev Heir, MD, DDS (2nd term) Hana Rashid, DDS (2nd term)

DELEGATES TO THE CDA HOUSE Bryan Judd, DDS (Ex Comm) Volki Felahy, DDS (ExComm) Margaret Delmore, MD, DDS (ExComm) Carl Hillendahl, DDS (ExComm) Wes Yee, DDS (Secretary Elect) (ExComm) Kelly Giannetti, DMD (2018-2019) Karthic Raghuraman, DDS 2018-2019) Jag Heir, MD, DDS (2018-2019) Kevin Keating, MS, DDS (2018-2019) Lisa Dobak, DDS (2018-2019) Stephanie Sandretti, DDS (2019-2020) Viren Patel, DDS (2019-2020) Hana Rashid, DDS (2019-2020) Mort Rosenberg, DDS (2019-2020)

Continuing:

Trustee: Adrian Carrington, DDS Board Members: Kevin Keating, DDS, MS; Brock Hinton, DDS

FOUNDATION SLATE OF NOMINEES BOARD OF DIRECTORS Slated for Election:

Continuing:

Paul Binon, DDS – first term, 2020-2021 Kelly Giannetti, DMD, MS – third term, 2020-2021 Bryan Judd, DDS – third term, 2020-2021 Wallace Bellamy, DMD – second term, 2020-2021 Wesley Yee, DDS – first term, 2020

Viren Patel, DDS Nancy Archibald, DDS Robert Daby, DDS Dennis Peterson, DDS Wai Chan, DDS Kent Daft, DDS

36 | The Nugget • Sacramento District Dental Society

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www.sdds.org • June / July 2019

| 37

Trustee Report June 7-8, 2019 Highlights of the CDA Board of Trustees Meeting The Board received updates on legal issues, legislative initiatives (sugar-sweetened beverage legislation, Medi-Cal funding, and SB 154 (Pan) expanding access to silver diamine fluoride) and TDSC Update on national expansion and efforts towards continual improvement of the online purchasing experience and outreach to component dental societies in 2019.

The Board also approved the following: • Presidential appointments and nominations to the Medicare Task Force and Council on Membership, CDA Foundation Audit Committee and Leadership Development Committee • Modified 2019 management objectives for the executive director, adding an objective related to organizational space needs (the Medicare task force has been established and The Dentists Supply Company (TDSC) has identified the need to merge Arnold Dental Supply within TDSC, making it one legal entity, similar to the merger of Dentists Benefits Insurance Company, Dentists Benefits Corporation and Northwest Dentists Insurance Company recently completed by TDIC). As such, it was recommended and approved by the Board that the proposed objective modifications be added to encompass this work • Amendments to the General Operating Principles of the 13th District Delegation for ADA; the recommended amendments are proposed to bring the GOPs up to date, to provide clarity around the responsibilities and activities of the delegation and eliminate duplicative language • Revisions to the CDA Foundation

Adrian Carrington, DDS & Terry Jones, DDS

bylaws to reflect a new Board composition and committee selection processes • The oversight transition of the CDA Well-Being Committee from the Council on Membership to the CDA Foundation Board of Directors • Changes to the CDA Peer Review Manual with the procedural and administrative elements streamlined into a procedural document maintained by the Council on Peer Review. (Since the implementation of mediation, the Council has proposed potential simplification of the manual so that the program policies are separated from internal administrative procedures.)

• The Board voted to rescind resolution 19-2018-B, the establishment of the Value of Community task force. This resolution called on CDA to develop a task force to review the current tripartite membership structure and rules; and recommend a component structure and procedures for selecting components that are member centric, transparent and inclusive. The Board felt that the parallel Board composition task force objectives and the Council on Membership work have been prioritized and should be completed before addressing the community issues in the resolution.

• To provide $15,000 from strategic reserves to support the 2019 candidacy of Dr. Alan Felsenfeld for ADA Speaker of the House • The 2020 CDA Cares event be held in Long Beach at the Long Beach Convention and Entertainment Center, July 17-18, 2020 • Filed the 2018 consolidated financial statements for CDA and its subsidiaries

38 | The Nugget • Sacramento District Dental Society

SDDS Trustees

• Funding of up to $175,000 to examine the dental office staffing workforce pipeline and develop a promotional campaign to support careers in dentistry (particularly dental hygienists and dental assistants) • The 2019 House of Delegates be held November 15-16 at the Hyatt Regency in Sacramento (Additionally, the Board also approved that future House of Delegates reflect the twoday schedule (pared down from three days). The two-day schedule provides an opportunity to maximize addressing association business, debate of resolutions and networking, while streamlining the leadership installations.

The Board was updated on several 2018 resolutions from the House of Delegates: Resolution 1B, ADA bylaws alignment - shared component zip codes - CDA has conducted an analysis of zip codes, identifying shared zip codes amongst 15 component dental societies, while also identifying how many potential members fall within each. CDA is currently working with the identified components to create feasible solutions, which could potentially result in revisions to the existing charters, eliminating several shared zip codes.

Resolution 8, Use of botulinum toxin and dermal fillers - Subsequent to the House directive, CDA submitted a request to the Dental Board requesting that this issue be placed on an upcoming meeting agenda.

However, on April 8, the Dental Board responded to CDA’s request stating that they have been clear in their interpretation and there is no need for the regulatory clarity CDA seeks. The Dental Board stated that “…cosmetic procedures and the use of appropriate products for those procedures that are performed for one of

the purposes laid out in §1625, and are documented as part of a dental treatment plan do fall within the definition of the practice of dentistry.” CDA has established a communication plan to distribute this information to members.

Resolution 14, Benefits for diagnostic oral health tests - CDA has established a government affairs council workgroup to evaluate existing policy related to patient benefits for diagnostic oral health tests.

The workgroup is expected to conduct their work over the next several months.

Resolution 15, Nutrition’s effect on oral/ systemic health - CDA is in the process of evaluating where members currently receive

nutritional information and education in order to identify potential gaps.

Resolution 18, Dental benefit data collection - CDA has established a new process for collecting member dental benefit inquiries, releasing a Dental Benefits Issue Submission Form, which is available to all tripartite members. An outreach plan to educate members regarding the new form commenced on May 1. This form will allow for enhanced tracking and reporting, which will assist CDA in identifying any additional resources and tools that may be needed in order to address the issue(s).

and was primarily focused on ensuring that the members of the task force were knowledgeable of the issue and presenting information as to what other entities are currently evaluating; the task force will receive information from ADA’s Health Policy Institute, as well as research regarding physician’s experience with Medicare.

Next CDA Board of Trustees Meeting: August 23-24, 2019

Resolution 19, Medicare task force - The task force held its first meeting in May

        

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  gpdevelopmentcorp.com | 916.332.2300 10604 Industrial Avenue, Suite 150, Roseville, CA 95678 www.sdds.org • June / July 2019

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TOTAL MEMBERSHIP (as of 6/11/19:)

1,754 MARKET SHARE: 82.9% RETENTION RATE: 95.6% ENGAGEMENT RATE: 83%

New Members ANDRE BARAKAT, DDS

General Practice

Dr. Barakat just graduated in 2019 and earned his dental degree at UOP Arthur A. Dugoni School of Dentistry Fun Fact: Dr. Barakat loves to play the guitar, do nature photography and is an amateur car racer.

BROCK DAVIDSON, DDS

General Practice

Dr. Davidson just graduated in 2019 and earned his dental degree at UOP Arthur A. Dugoni School of Dentistry.

TOTAL AFFILIATE MEMBERS: 14 TOTAL STUDENT MEMBERS: 9 TOTAL CURRENT APPLICANTS: 7 TOTAL DHP MEMBERS: 45 TOTAL NEW MEMBERS FOR 2019: 62

Dr. Hsieh earned his dental degree from UCSF School of Dentistry in 2017 and currently practices in Antelope.

ANDREW LAFLAMME, DDS

Transferred from San Francisco Dental Society Orthodontics

Dr. Dooley earned her dental degree from Herman Ostrow School of Dentistry in 2010 and currently practices in Placerville.

Pediatric Dentistry

VERA DOOLEY, DDS

Dr. Erickson earned his dental degree at Virginia Commonwealth University in 2010 Fun Fact: Dr. Erickson has been attacked by elephants on more than one occasion, practiced dentistry in 10 different countries and circumnavigated the globe on accident!

TOTAL DUAL MEMBERS: 9

JUNG HSIEH, DDS

Transferred from Southern Alameda County Dental Society General Practice

General Practice

Transferred from Mid-Peninsula Dental Society General Practice

TOTAL RETIRED MEMBERS: 293

2019

Dr. LaFlamme earned his dental degree at UOP Arthur A Dugoni School of Dentistry and is doing his post-graduate at UOP. Fun Fact: Dr. LaFlamme really enjoys mowing the lawn when he is not practicing dentistry.

BRANDON ERICKSON, DDS

TOTAL ACTIVE MEMBERS: 1,375

June / July

ABRAHAM PRIESTLEY, DDS

ck!

Welcome Ba

Dr. Priestley earned his dental degree at UOP Arthur A Dugoni School of Dentistry and practices at Cali Kids Dental in Auburn, CA and Roseville Kids Dentist in West Roseville.

SUZANNE SAIDI, DDS

Transferred from Contra Costa Dental Society General Practice

MICHELLE FAT, DDS

Dr. Saidi earned her dental degree at UOP Arthur Dugoni School of Dentistry and currently practices in Sacramento.

Dr. Fat just graduated in 2019 and earned her dental degree at UOP Arthur A. Dugoni School of Dentistry.

General Practice

General Practice

HANNAH FOX, DDS

General Practice

Dr. Fox just graduated in 2019 and earned her dental degree at UOP Arthur A. Dugoni School of Dentistry and is doing her Residency at the Veteran Affairs Northern California Medical Center.

GABRIEL GUEVARA, DDS

Transferred from San Fernando Dental Society General Practice Dr. Guevara earned his dental degree from University of the East Dentistry in 1991 and currently practices in Sacramento.

KEVIN HO, DDS

Transferred from Tri County Dental Society General Practice Dr. Ho earned his dental degree from the Western University of Health Sciences College of Dental Medicine in 2018.

CATHY VO, DMD

Dr. Vo earned her dental degree at Arizona School of Dentistry in 2017.

New Student Member: Kylee Homecillo

Pending Applicants: Feras Al Riyabi, DDS Ayman Ghobashy, DDS Cuauhetomo Gonzalez, DDS Johanna Hsieh, DDS Maria Nunez-Ouji, DDS James Van Sicklin, DDS (affiliate)

Congratulations

to Our New Retired Members!

Phillip Camfield, DDS Douglas Lott, DDS

WESTERN PRACTICE SALES Your Life’s Work Comes Down To This Decision What separates us from other brokerage firms?

Western Practice Sales is locally owned by dentists and has been proudly serving dentists in the SDDS Marketplace for over 45 years. Our personal attention to our sellers and reputation of integrity and honesty has made us Northern California’s Preferred Dental Practice Broker.

Our extensive buyer database allows us to offer you…

Better Exposure Better Fit Better Price!

Call or email today for a free copy of Dr Giroux’s book Top Ten Issues for Dentists Contemplating Retirement in Ten Years or Less

800.641.4179 westernpracticesales.com

ASK THE BROKER How do you determine the listing price of my practice?

The single-most important factor in determining the practice sales price is the collection total of the previous calendar year. Lenders and Buyers like to see stability without large variances from year to year. It should be obvious that steady, slight increases in revenues are always better than even the slightest of decreases. Poor performance of one of three years should not affect pricing, unless it is the last calendar year that shows a significant drop. Therefore, try to maintain a stable practice, make sure you finish strong and make all your December deposits for that last year you will be filing!

Practices are priced based heavily on gross receipts.

Let’s work through some scenarios and options. If you plan to practice 2-3 more years, it is not worth investing extra money in the practice. In this case, I would just advise finishing strong, especially to reflect your last tax return which will be filed. If you plan to practice approximately 5 years, spending large amounts of money for new technology may not necessarily return the investment unless it helps to increase your production.

However, this being said, purchasing new equipment may increase your enjoyment of practicing dentistry and therefore be a worthwhile investment.

With 8–10 years remaining to practice, modernizing the practice with the latest and greatest is generally a great idea. Leasehold improvements typically last 5-8 years, so making the investment at this time to spruce up the office will enhance the desirability of the sale. It may also give you greater satisfaction of working in a first-rate environment for the entire duration of the leasehold improvements. Most importantly, since practice values are based on gross receipts, keep up the good work!

With factors affecting the current practice market such as a large number of “Baby Boomers” choosing to retire coupled with a lower percentages of Millennials wanting to own dental practices, it is important to make decisions now that will help your practice stand out from the rest when you decide to sell! Call or email us today for a free copy of Dr Giroux’s book “Top Ten Issues for Dentists Contemplating Retirement in Ten Years or Less”.

Timothy G. Giroux, DDS is currently the Owner & Broker at Western Practice Sales and a member of the nationally recognized dental organization, ADS Transitions.

You may contact Dr Giroux at: wps@succeed.net or 800.641.4179

Paid advertisement www.sdds.org • June / July 2019

| 41

We’re Blowing your horn!

Congratulations to...

Adrian J. Carrington, DDS, Marsha Henry, DDS, and their two daughters, for being at the Today Show! They were there celebrating birthdays and a medical school graduation! (1)

1

Matthew Korn, DDS, on the Grand Opening of his Rocklin location of Aria Dental Implants & Periodontics! (2) David Jolkovsky, DMD, MS and Rob Berrin, DDS, on being co-honored at the 46th Annual Meeting of the California Society of Periodontics in Laguna Niguel for their "Outstanding Contributions to Periodontics!" Presenting the Award was Dr. Kevin Chen, President of The California Society of Periodontics!

Congrats on your recognition! (3) Aneel Nath, DDS, on his recent big catch! Just look at the size of that blue fin tuna! Happy birthday Dr. Nath! (4)

2

Mort Rosenberg, DDS, on the birth of his very first grandchild!

Chloe was born on February 16th to her parents who live in France.

Dr. Rosenberg went out to visit back in March to see his new grandbaby! Dr. Rosenberg also got married on April 12th to Cindy, who he has been with for the last 5 years. (5)

LET US KNOW YOUR NEWS! Get married? Pass your boards? Got published? Let us know your good news and we will feature it in "Blowing Your Horn."

Send us your news to sdds@sdds.org to let everyone know about the great things that are happening!

4

3

5 42 | The Nugget • Sacramento District Dental Society

SPOTLIGHTS: DESCO began in the mid-eighties as a service only company. As we grew, more requests came for us to become an equipment resource.

We became multi-line suppliers for all types of dental equipment.

While we still have our roots in the service and maintenance of all types of dental equipment, in the last 25 years we have expanded our scope of work to include: new equipment sales, office design and construction, relocations and remodels. The equipment we service ranges from handpieces to digital x-ray and everything in between.

Being a family owned business allows us the flexibility to personalize our sales and service to your needs. Our integrity and professionalism is what you remember of us and we never forget we are working for you.

We look forward to the opportunity to be the source for all of your equipment needs.

Make sure to like us on Facebook: facebook.com/descodental

Products and Services: • • • •

New equipment sales Service, repair and maintenance of existing equipment New office design, construction and TI’s Office relocations

Benefits or Special Pricing for SDDS Members: • Amalgam Separator Special – Solmetex amalgam separator, $825.00 with free installation.

• Free equipment evaluation (call to schedule)

Tony Vigil; President tony.desco@gmail.com cell: (916) 747-8232 DescoDentalEquipment.com ph: (916) 259-2838

COMCAST BUSINESS offers Ethernet, Internet, Wi-Fi, Voice and TV solutions to help organizations of all sizes transform their business.

Powered by a next-generation, fiber-based network, and backed by 24/7 technical support, Comcast Business is one of the largest contributors to the growth of Comcast Cable.

Products and Services: Comcast Business Internet provides a fast, reliable, secure and scalable Internet solution enabling you to better connect with employees, customers and suppliers, saving you time and money. Offering download speeds up to 1 Gig and upload speeds up to 35 Mbps. Access valuable extras such as private WiFi for your employees, public WiFi for your customers, and Static or Dynamic IP addresses.

With Comcast Business Ethernet, you can bypass the public Internet and exchange data safely and securely at up to 10Gbps, helping your organization to operate at peak performance.

With Comcast Business Voice, you get a reliable business phone service that’s best in call clarity. You also get unlimited local and domestic long distance calling and advanced business phone management features designed to help you be more competitive – all included at no extra cost.

Business VoiceEdge offers a complete managed voice solution in which all voice communications services are managed by Comcast.

Comcast Business TV will keep you and your employees connected to the community and nation events that impact your day-to-day business.

Plus, entertain customers in your waiting room or lobby with a variety of packages designed to meet the needs of any business.

Comcast Business SmartOffice™ Video Monitoring Solution

Lisa Geraghty, Business Account Executive lisa_geraghty@cable.comcast.com Business.Comcast.Com ph: (916) 817-9284

Olson Construction, Inc. is a design/build construction firm who can take your office from design to finish. They have proven themselves to be the go-to company when you want your dental office done on time and within budget.

Star Group is a refiner of precious scrap metal for the dental industry.

We are proud to be associated with the SDDS program “Crowns For Kids”, a scrap recycling program, which gives back to the children’s community healthcare foundation program.

Products and Services:

Products and Services:

• Complete architectural and engineering services for obtaining large or small remodels and new tenant improvements • Turn-key construction with continued support

We recycle precious dental waste on behalf of the SDDS Foundation for their “CROWNS FOR KIDS” program. Please contact your local representative, Jim Ryan.

David Olson info@olsonconstructioninc.com

Star Group is a partner of the SDDS Foundation Smiles for Kids and Crowns for Kids programs.

OlsonConstructionInc.com ph: (209) 366-2486

Jim Ryan jryan@stargroupUS.com StarGroupUS.com ph: (800) 333-9990

www.sdds.org • June / July 2019

| 43

Tony Vigil, President 916.259.2838 descodentalequipment.com

Patterson Dental

Jose Gallardo, Sales Manager

Roy Fruehauf, Branch Manager

775.829.4488

800.736.4688

lumadent.com

pattersondental.com

Since 2015

Since 2005

DENTAL

The Vendor Membership program offers so many great benefits!

As a Vendor Member, you'll receive: four complimentary half page ads in The Nugget, a booth at our MidWinter Convention (including registrations for 4 booth representatives), the SDDS Membership Roster (send out quarterly via email), complimentary exhibitor tables at 3 meetings/events per year, and much more!

Olson Construction, Inc.

Parc Studio-Interior Design

Gary Perkins 916.332.2300 gpdevelopmentcorp.com

David Olson 209.366.2486 olsonconstructioninc.com

Claire Blocker / April Figgess 916.476.3982 parc-studio.com

Professional Practice Sales

Brian Flanagan 855.337.4337 integritypracticesales.com

Ray Irving 415.899.8580 PPSsellsDDS.com

Since 2018 Since 2015

Western Practice Sales

Since 2014

Lisa Geraghty 916.817.9284 lisa_geraghty@cable.comcast.com

44 | The Nugget • Sacramento District Dental Society

we love

our Vendor Members!

Tim Giroux, DDS, President John Noble, MBA 800.641.4179 westernpracticesales.com Since 2007

Comcast Business

of The Great West

Jim Ryan 800.333.9990 stargrouprefining.com Since 2009

Since 2016

kidscaredental.com

Star Group Global Refining

LaDonna Drury-Klein 916.358.3825 thefade.org

Since 2017

Since 2016

Jeff Summers 916.661.5754

Since 2014

Kids Care Dental

The Foundation for Allied Dental Education

Since 2004

Kim Gusman, Executive VP Mari Bradford, HR Hotline 800.399.5331 employers.org

Education

Integrity Practice Sales

CA Employers Association

Keith B. Dunnagan, Senior Attorney 916.966.2260 bpelaw.com/dental-law

Dental Refining

HR & Legal

BPE Law Group, PC

Practice Sales

Since 2016

Since 2004

GP Development Inc.

Morgan Davis / Lynda Doyle 916.772.4192 bluenorthernbuilders.com

Since 2007

Office Construction Dental Practice

Sahel Sayfie 408.649.8921 KulzerUS.com

Blue Northern Builders, Inc.

THIS COULD BE YOU!

Practice Services

Kulzer, LLC

WHY BECOME A VENDOR MEMBER?

Since 2003

LumaDent, Inc

Henry Schein Dental Farish Thompson, Regional Manager 916.626.3002 henryschein.com

Since 2012

Since 2004

DESCO Dental Equipment

Steve Shupe, VP 888.928.1068 asimedical.com

Since 2018

Dental Supplies, Equipment, Repair

Analgesic Services, Inc.

CareCredit

Shannon Mitchell, VP, Business Banking Officer 916.648.3470 bannerbank.com

Angela Martinez 714.434.4508 carecredit.com

US Bank

Access Dental Plan

Health Net of California

LIBERTY Dental Plan

Lisa Rufo 916.563.6030 premierlife.com

Felisha Fondren 818.543.9007 hndental.com

Danielle Cannarozzi 888.703.6999 libertydentalplan.com

Since 2018

First US Community Credit Union Gordon Gerwig, Business Services Mgr 916.576.5679 firstus.org

John Urrutia, CPA, Partner 916.724.3980 muncpas.com

Doug Van Order 916.878.3341 northerncalifornia.massmutual.com

Since 2010

Swiss Monkey Christine Sison 916.500.4125 swissmonkey.co

Debbie Kemper 916.993.4182 resourcestaff.com

The Dentists Insurance Company Kelli Young 800.733.0633 tdicsolutions.com Since 2011

Insurance Services

Since 2018

Since 2003

THIS COULD BE YOU!

Resource Staffing Group

Since 2016

Staffing

Since 2017

Since 2005

Since 2009 Since 2017

Since 2017

Tom Collopy 916.924.4546 usbank.com

MUN CPAs

MassMutual Northern California

Since 2016

Craig Fechter, CPA 916.333.5360 fechtercpa.com

Since 2016

Financial Services

Banner Bank

Brandon Dena 916.767.4462 bankofthewest.com

Since 2017

Financial Services

Fechter & Company

Dental Plan

Bank of the West

Jason Mata 800.455.0986 dentalmortgage.com

Since 2016

Financial Services

American Pacific Mortgage

SDDS VENDOR MEMBERSHIP SUPPORT IS A WIN-WIN RELATIONSHIP! SDDS started the Vendor Member program in 2002 to provide resources for our members. No, Vendor Members are not exclusive, and we definitely have some competitive companies who are Vendor Members. But our goal is to give SDDS members resources that would best serve their needs. We suggest that members reach out to our Vendor Members and see what is a best “fit” for their practice and lifestyle.

We currently have 34 Vendor Members. They pay $3,900 per year; that includes a booth at Midwinter, three tables at General Meetings, advertising in The Nugget, and much more. Our goal is to provide Vendor Members with the opportunity to connect with and serve our members. We realize that you have a choice for vendors and services; we only hope that you give our Vendor Members first consideration.

The Vendor Members program and the income SDDS receives from this program helps to keep your dues low. It is a wonderful source of non-dues revenue and allows us to provide yet another member benefit. Additionally, we reach out to our Vendor Members for articles for The Nugget (nonadvertising!).

Our Vendor Members are financial, investment and insurance companies, legal consultants, dental equipment and supply companies, media and marketing companies, hr consultants, construction companies, billing consultants, practice sales and brokers, practice resource and staffing consultants, technology, HIPAA and security consultants, and even our Crowns for Kids refining partner!

www.sdds.org • June / July 2019

| 45

Advertiser INDEX Dental Supplies, Equipment, Repair Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

Analgesic Services Inc. . . . . . . . . . . . . . . . . . . . 19, 44 Burkhart Dental Supply. . . . . . . . . . . . . . . . . . . . . . . 11 Desco Dental Equipment. . . . . . . . . . . . . . . . . . . . . 44 Henry Schein Dental. . . . . . . . . . . . . . . . . . . . . . 37, 44 Kulzer, LLC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27, 44 LumaDent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35, 44 Patterson Dental. . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Dental Practice Vendor Member

Kids Care Dental . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Education Vendor Member

The Foundation for Allied Dental Education. . 4, 44, 46 Dr. Pieter Linssen . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Financial Services Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member Vendor Member

American Pacific Mortgage . . . . . . . . . . . . . . . . 17, 45 Bank of the West . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Banner Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . 35, 45 Care Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Central Valley Community Bank . . . . . . . . . . . . . . . . 15 Fechter & Company. . . . . . . . . . . . . . . . . . . . . . . . . 45 First US Community Credit Union . . . . . . . . . . . . . . 45 MUN CPAs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 MassMutual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 US Bank . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27, 45

Our Foundation and KB Dental Arts are excited to announce our partnership in publishing The California RDA Combined Written and Law Examination Preparation Book and Student Study Card Set. This examination prep book is the latest edition meeting the needs of dental assistants looking for the perfect resource by which to prepare for their licensing examinations.

Take advantage of ordering the best selling examination prep book in the State.

Human Resources & Legal Vendor Member Vendor Member

BPE Law Group . . . . . . . . . . . . . . . . . . . . . . . . . 11, 44 California Employers Association (CEA) . . . . . . . . . . 44

Insurance Services Vendor Member Vendor Member Vendor Member Vendor Member

Access Dental Plan . . . . . . . . . . . . . . . . . . . . . . . . . 45 Health Net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 LIBERTY Dental Plan . . . . . . . . . . . . . . . . . . . . . 31, 45 TDIC & TDIC Insurance Services . . . . . . . . . . . . . 8, 45

CALIFORNI

General Writteno& Law Examinati n P R E PA R AT I O

N BOOK

nas, CDA, Colleen Kirby-Ba

Office Design & Construction Vendor Member Vendor Member Vendor Member Vendor Member

BINED A RDA COM

RDAEF, BS, MS

Blue Northern Builders, Inc. . . . . . . . . . . . . . . . . 33, 45 GP Development Inc. . . . . . . . . . . . . . . . . . . . . . 39, 45 Olson Construction . . . . . . . . . . . . . . . . . . . . . . 19, 45 Parc Studio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Practice Sales Vendor Member Vendor Member Vendor Member

Practice Services Vendor Member

Comcast Business. . . . . . . . . . . . . . . . . . . . . . . 13, 44

Staffing Vendor Member Vendor Member

Resource Staffing Group . . . . . . . . . . . . . . . . . . 13, 45 Swiss Monkey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Waste Management Services Vendor Member

018 DITION | 2 BLENDED E

Galster Real Estate Group . . . . . . . . . . . . . . . . . . . . 33 Henry Schein Financial . . . . . . . . . . . . . . . . . . . . . . . 5 Integrity Practice Sales . . . . . . . . . . . . . . . . . . . . . . 44 Professional Practice Sales . . . . . . . . . . . . . . . . 21, 44 Western Practice Sales . . . . . . . . . . . . . . . . . . . 41, 44

Star Group Global Refining . . . . . . . . . . . . . . . . . . . 45

THREE CONVENIENT WAYS TO ORDER!

Phone: Website: Email:

650.762.4020 www.theFADE.org ColleenKirby@thefade.org Published By:

46 | The Nugget • Sacramento District Dental Society

Classified Ads EMPLOYMENT OPPORTUNITIES

FOR LEASE

FOR LEASE

Join our dental team in a family oriented new office. We are looking for a full-time front desk with experience, some training, (we use PWorks), a parttime hygienist and a part-time RDA. Please call today: 916-684-8373 6-7/19c

Dental office for lease in El Dorado Hills. 2 operatories fully equipped and 3rd plumbed. 1300 sq feet, modern furnished private office with full bath, plus employee lounge. All utilities and janitorial included. Call (916) 230-5195 and leave a message for appointment. 6 -7/19c

WELLSPACE HEALTH ORGANIZATION (an FQHC) is taking applications for fill-in/part-time/full-time dentists. Send your resume/CV to eljohnson@ wellspacehealth.org.

01/15

Rocklin dental office sublease 1,300 sf, 3 operatories, perfect for a startup; Roseville dental office lease 1,386 sf, 5 operatories, Fully improved move-in ready suites; Ranga Pathak (916) 201-9247, Broker Associate, RE/ MAX Gold, BRE01364897 6-7/19

SACRAMENTO DENTAL COMPLEX has one 3 unit suite which is equipped for immediate occupancy. Two other suites total 1630 sq. ft which can be remodeled to your personal office design with generous tenant improvements. 2525 K Street. Please call for details: 916-448-5702.

10/11

Kids Care Dental & Orthodontics seeks Dentists to join our teams in the greater Sacramento and greater Stockton areas. We believe when kids grow up enjoying the dentist, healthy teeth and gums will follow. As the key drivers of our mission—to give every kid a healthy smile—our dentists, orthodontists and oral surgeons exhibit a genuine love of children and teeth.

A good fit for our culture means you are also honest, playful, lighthearted, approachable, hardworking, and compassionate. Patients love us...come find out why!

Send your resume to talent@kidscaredental.com. 06-7/17 Kids Care Dental & Orthodontics seeks Orthodontists to join our teams in the greater Sacramento and greater Stockton areas. We believe when kids grow up enjoying the dentist, healthy teeth and gums will follow.

As the key drivers of our mission—to give every kid a healthy smile—our dentists, orthodontists and oral surgeons exhibit a genuine love of children and teeth.

A good fit for our culture means you are also honest, playful, lighthearted, approachable, hardworking, and compassionate. Patients love us...come find out why!

Send your resume to talent@kidscaredental.com. 06-7/17

SDDS member dentists can MEMB place one classified ad ER

FOR FREE!

BENEF

IT!

Dental practice, building, and real estate for sale ($999K) or unit for lease ($2250/mo). Long-time tenants. 5000+ sqft. 321 State Hwy 49, Sutter Creek. RE Broker #01788488 Jay Emerson 916-517-9606 6-7/19 Rocklin office. 2,000+ sq. ft. 4 ops, x-rays, computers in back. Laundry on site. Plenty of parking. Management will work with new lease for entry deal. Call Nancy 916778-7653 6-7/19c Office Space Available for Lease from 1,500 sq ft to 10,000 sq ft. Located at 3732 Auburn Blvd cross street Watt Ave. Contact Benny at 916-716-8506 3/19 Beautiful new building just completed in Auburn with optimal visibilty, ideal location and ample ADA parking. We will help design, finance, build and market your relocation! Lease with future purchase option.

2-11,000 sqft spaces available for your dream office! www.3130ProfessionalDrive.com 1/19 Elegant, furnished dental suite (2000 sq. ft) Located in custom East Sacramento dental building w/on-site parking.

All upscale amenities including 4 operatories, lab, business office, private Drs. Office w/full bath, plus bonus room w/ storage. Long-term lease available. For apt. or further info call 916-346-0041 and leave message.

1/18 EXCLUSIVE, PRIVATE DENTAL SUITE; 1200 sq. ft., completely remodeled w/upscale amenities: 3 operatories, lab, reception, business office w/ breakroom, private Doctor's office w/bath. Suite is located in a custom dental building w/on-site parking and handicapped access near Country Club Center. If requested, owner will furnish finish equipment upfront: amortize over long term lease (5-10 years). For appt. or further info, call 916-346-0041 5/16

EQUIPMENT FOR SALE

Planmeca Promax Panoramic and Ceph X-ray system.

Exposure count total 14,913. Purchased new in 2005.

Excellent condition, shipping and install not included.

Comes with 2nd sensor. 20k OBO. contact: amber@ sacortho.com 1/19

PROFESSIONAL SERVICES

MONEY IS WALKING OUT THE DOOR. Have implants placed in your office and keep the profits. Text name and address 916-769-1098.

12/14 LEARN HOW TO PLACE IMPLANTS IN YOUR OFFICE OR MINE. Mentoring you at your own pace and skill level.

Incredible practice growth. Text name and address to 916-952-1459.

04/12 To place an ad in The Nugget Classifieds, visit www.sdds.org/NUGGET.html

Selling your practice? Need an associate? Have office space to lease? SDDS member dentists get one complimentary, professionally related classified ad per year (30 word maximum). For more information on placing a classified ad, please call the SDDS office at 916.446.1227. www.sdds.org • June / July 2019

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PRSRT STD US POSTAGE PAID PERMIT NO. 557

2035 Hurley Way, Suite 200 • Sacramento, CA 95825 916.446.1211 • www.sdds.org

SACRAMENTO, CA

ADDRESS SERVICE REQUESTED

SDDS CALENDAR OF EVENTS JULY

SEPTEMBER

12 Peer Review Calibration Workshop CDA

3

AUGUST

5-7 ADA Scientific Sessions in SF 5

2 ExComm Meeting 7am / Offsite 7

9

HR Webinar OSHA Inspections, What They Look For! California Employers Association CE 12–1:00pm / Telecom CPR BLS Renewal 8:00am / SDDS Office

CE

Board Meeting 6pm / SDDS Office Webinar Harassment Prevention for Employees California Employers Association CE 12–1:00pm / Telecom

10 General Membership Meeting Human Trafficking: Identify/Respond to Victims in the Clinical Setting Ron Chambers, MD, FAAFP & Jennifer Cox Hilton Sacramento Arden West CE 5:45pm Social / 6:45pm Dinner & Program

For more calendar info and to sign up for courses ONLINE, visit: www.sdds.org

16 Member Engag./Recruit. Meeting 6:30pm / SDDS Office 18 Business Forum Dental Benefit Contracts in Your Practice Cindy Hartwell; CDA 6:30pm / SDDS Office

CE

20 Continuing Education Course Denti-Cal, GMC Billing Symposium – for Dentist Providers and Front Office Staff Panel of Experts CE 8:30am / SDDS Office 21 River Boat Cruise

OCTOBER 5, 2019 A Gala to Benefit the Sacramento District Dental Foundation

General Meeting 3 CEU, CORE • $75

SEP

10

Human Trafficking: How to Identify and Respond to Victims in the Clinical Setting Presented by Ron Chambers, MD, FAAFP & Jennifer Cox Course Overview: • Discuss the prevalence of human trafficking in our community and identify where it occurs.

TUESDAY 5:45PM-9PM

• Explain the warning signs and symptoms to identify a human trafficking victim and how to responds appropriately in collaboration with law enforcement, community agencies, and other healthcare professionals.

5:45pm: Social & Table Clinics 6:45pm: Dinner & Program

• Describe trauma informed care techniques to avoid retraumatization when providing care.

Hilton Sacramento Arden West (2200 Harvard Street, Sac)

ARE YOU REGISTERED FOR THE GENERAL MEETING?